Curved tip surgical stapler buttress assembly applicator with proximal alignment features

ABSTRACT

A buttress applier cartridge assembly includes buttress assemblies and a buttress applier cartridge for use with an end effector of a surgical stapler. The buttress assemblies each include a buttress to support a staple formed therein as well an adhesive for adhering to the end effector. The buttress applier cartridge includes a housing, a platform that extends longitudinally and supports the buttress assemblies, and an opening to accommodate a curved tip of the end effector when clamping the end effector onto the platform to transfer the buttress assemblies to the end effector. A proximal alignment feature of the buttress applier cartridge contacts the end effector to align the end effector with the buttress assemblies prior to attaching the buttress assemblies to the end effector.

BACKGROUND

In some settings, endoscopic surgical instruments may be preferred overtraditional open surgical devices since a smaller incision may reducethe post-operative recovery time and complications. Consequently, someendoscopic surgical instruments may be suitable for placement of adistal end effector at a desired surgical site through the cannula of atrocar. These distal end effectors may engage tissue in a number of waysto achieve a diagnostic or therapeutic effect (e.g., endocutter,grasper, cutter, stapler, clip applier, access device, drug/gene therapydelivery device, and energy delivery device using ultrasound, RF, laser,etc.). Endoscopic surgical instruments may include a shaft between theend effector and a handle portion, which is manipulated by theclinician. Such a shaft may enable insertion to a desired depth androtation about the longitudinal axis of the shaft, thereby facilitatingpositioning of the end effector within the patient. Positioning of anend effector may be further facilitated through inclusion of one or morearticulation joints or features, enabling the end effector to beselectively articulated or otherwise deflected relative to thelongitudinal axis of the shaft.

Examples of endoscopic surgical instruments include surgical staplers.Some such staplers are operable to clamp down on layers of tissue, cutthrough the clamped layers of tissue, and drive staples through thelayers of tissue to substantially seal the severed layers of tissuetogether near the severed ends of the tissue layers. Merely exemplarysurgical staplers are disclosed in U.S. Pat. No. 4,805,823, entitled“Pocket Configuration for Internal Organ Staplers,” issued Feb. 21,1989; U.S. Pat. No. 5,415,334, entitled “Surgical Stapler and StapleCartridge,” issued May 16, 1995; U.S. Pat. No. 5,465,895, entitled“Surgical Stapler Instrument,” issued Nov. 14, 1995; U.S. Pat. No.5,597,107, entitled “Surgical Stapler Instrument,” issued Jan. 28, 1997;U.S. Pat. No. 5,632,432, entitled “Surgical Instrument,” issued May 27,1997; U.S. Pat. No. 5,673,840, entitled “Surgical Instrument,” issuedOct. 7, 1997; U.S. Pat. No. 5,704,534, entitled “Articulation Assemblyfor Surgical Instruments,” issued Jan. 6, 1998; U.S. Pat. No. 5,814,055,entitled “Surgical Clamping Mechanism,” issued Sep. 29, 1998; U.S. Pat.No. 6,978,921, entitled “Surgical Stapling Instrument Incorporating anE-Beam Firing Mechanism,” issued Dec. 27, 2005; U.S. Pat. No. 7,000,818,entitled “Surgical Stapling Instrument Having Separate Distinct Closingand Firing Systems,” issued Feb. 21, 2006; U.S. Pat. No. 7,143,923,entitled “Surgical Stapling Instrument Having a Firing Lockout for anUnclosed Anvil,” issued Dec. 5, 2006; U.S. Pat. No. 7,303,108, entitled“Surgical Stapling Instrument Incorporating a Multi-Stroke FiringMechanism with a Flexible Rack,” issued Dec. 4, 2007; U.S. Pat. No.7,367,485, entitled “Surgical Stapling Instrument Incorporating aMultistroke Firing Mechanism Having a Rotary Transmission,” issued May6, 2008; U.S. Pat. No. 7,380,695, entitled “Surgical Stapling InstrumentHaving a Single Lockout Mechanism for Prevention of Firing,” issued Jun.3, 2008; U.S. Pat. No. 7,380,696, entitled “Articulating SurgicalStapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism,”issued Jun. 3, 2008; U.S. Pat. No. 7,404,508, entitled “SurgicalStapling and Cutting Device,” issued Jul. 29, 2008; U.S. Pat. No.7,434,715, entitled “Surgical Stapling Instrument Having MultistrokeFiring with Opening Lockout,” issued Oct. 14, 2008; U.S. Pat. No.7,721,930, entitled “Disposable Cartridge with Adhesive for Use with aStapling Device,” issued May 25, 2010; U.S. Pat. No. 8,408,439, entitled“Surgical Stapling Instrument with An Articulatable End Effector,”issued Apr. 2, 2013; and U.S. Pat. No. 8,453,914, entitled “Motor-DrivenSurgical Cutting Instrument with Electric Actuator Directional ControlAssembly,” issued Jun. 4, 2013. The disclosure of each of theabove-cited U.S. Patents and U.S. Patent Publications is incorporated byreference herein.

While the surgical staplers referred to above are described as beingused in endoscopic procedures, it should be understood that suchsurgical staplers may also be used in open procedures and/or othernon-endoscopic procedures. By way of example only, a surgical staplermay be inserted through a thoracotomy and thereby between a patient'sribs to reach one or more organs in a thoracic surgical procedure thatdoes not use a trocar as a conduit for the stapler. Such procedures mayinclude the use of the stapler to sever and close a vessel leading to alung. For instance, the vessels leading to an organ may be severed andclosed by a stapler before removal of the organ from the thoraciccavity. Of course, surgical staplers may be used in various othersettings and procedures.

Examples of surgical staplers that may be particularly suited for usethrough a thoracotomy are disclosed in U.S. Pat. No. 9,186,142, entitled“Surgical Instrument End Effector Articulation Drive with Pinion andOpposing Racks,” issued Nov. 17, 2015; U.S. Pat. No. 9,717,497, entitled“Lockout Feature for Movable Cutting Member of Surgical Instrument,”issued Aug. 1, 2017; U.S. Pat. No. 9,517,065, entitled “IntegratedTissue Positioning and Jaw Alignment Features for Surgical Stapler,”issued Dec. 13, 2016; U.S. Pat. No. 9,839,421, entitled “Jaw ClosureFeature for End Effector of Surgical Instrument,” issued Dec. 12, 2017;U.S. Pat. No. 9,867,615, entitled “Surgical Instrument with ArticulationLock having a Detenting Binary Spring,” issued Jan. 16, 2018; U.S. Pat.No. 9,622,746, entitled “Distal Tip Features for End Effector ofSurgical Instrument,” issued Apr. 18, 2017; U.S. Pat. No. 10,092,292,entitled “Staple Forming Features for Surgical Stapling Instrument,”issued Oct. 9, 2018; U.S. Pat. No. 9,795,379, entitled “SurgicalInstrument with Multi-Diameter Shaft,” issued Oct. 24, 2017; and U.S.Pat. No. 9,808,248, entitled “Installation Features for SurgicalInstrument End Effector Cartridge,” issued Nov. 7, 2017. The disclosureof each of the above-cited U.S. Patent Publications is incorporated byreference herein.

Additional surgical stapling instruments are disclosed in U.S. Pat. No.8,801,735, entitled “Surgical Circular Stapler with Tissue RetentionArrangements,” issued Aug. 12, 2014; U.S. Pat. No. 8,141,762, entitled“Surgical Stapler Comprising a Staple Pocket,” issued Mar. 27, 2012;U.S. Pat. No. 8,371,491, entitled “Surgical End Effector Having ButtressRetention Features,” issued Feb. 12, 2013; U.S. Pat. No. 9,597,082,entitled “Method and Apparatus for Sealing End-to-End Anastomosis”issued Mar. 21, 2017; U.S. Pat. No. 9,398,911, entitled “Rotary PoweredSurgical Instruments with Multiple Degrees of Freedom,” issued Jul. 26,2016; U.S. Pat. Pub. No. 2013/0206813, entitled “Linear Stapler,”published Aug. 15, 2013, now abandoned; U.S. Pat. Pub. No. 2008/0169328,entitled “Buttress Material for Use with a Surgical Stapler,” publishedJul. 17, 2008, now abandoned; U.S. Pat. No. 9,848,871, entitled “Wovenand Fibrous Materials for Reinforcing a Staple Line,” issued Dec. 26,2017; U.S. Pat. No. 9,936,954, entitled “Devices and Methods for SealingStaples in Tissue” issued Apr. 10, 2018; and U.S. Pat. Pub. No.2016/0089146, entitled “Circular Fastener Cartridges for ApplyingRadially Expandable Fastener Lines” published Mar. 31, 2016, issued asU.S. Pat. No. 10,426,476 on Oct. 1, 2019. The disclosure of each of theabove-cited U.S. Patents, U.S. Patent Publications, and U.S. PatentApplications is incorporated by reference herein.

In some instances, it may be desirable to equip a surgical staplinginstrument with a buttress material to reinforce the mechanicalfastening of tissue provided by staples. Such a buttress may prevent theapplied staples from pulling through tissue and may otherwise reduce arisk of tissue tearing at or near the site of applied staples.

While various kinds of surgical stapling instruments and associatedcomponents have been made and used, it is believed that no one prior tothe inventor(s) has made or used the invention described in the appendedclaims.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the invention,and, together with the general description of the invention given above,and the detailed description of the embodiments given below, serve toexplain the principles of the present invention.

FIG. 1 depicts a perspective view of an exemplary articulating surgicalstapling instrument;

FIG. 2 depicts a side view of the instrument of FIG. 1;

FIG. 3 depicts a perspective view of an opened end effector of theinstrument of FIG. 1;

FIG. 4A depicts a side cross-sectional view of the end effector of FIG.3, taken along line 4-4 of FIG. 3, with the firing beam in a proximalposition;

FIG. 4B depicts a side cross-sectional view of the end effector of FIG.3, taken along line 4-4 of FIG. 3, with the firing beam in a distalposition;

FIG. 5 depicts an end cross-sectional view of the end effector of FIG.3, taken along line 5-5 of FIG. 3;

FIG. 6 depicts an exploded perspective view of the end effector of FIG.3;

FIG. 7 depicts a perspective view of the end effector of FIG. 3,positioned at tissue and having been actuated once in the tissue;

FIG. 8 depicts a perspective view of an alternative version of an endeffector with an angled anvil and an angled cartridge;

FIG. 9 depicts an enlarged, side view of the end effector of FIG. 8;

FIG. 10 depicts an enlarged top view of the end effector of FIG. 8;

FIG. 11 depicts a perspective view of an exemplary surgical staplinginstrument having an end effector with a bent or angled elasticallydeformable tip section;

FIG. 12A depicts an enlarged side view of a distal portion of the endeffector of FIG. 11;

FIG. 12B depicts an enlarged side view of a distal portion of analternate end effector similar to that of FIG. 11;

FIG. 13 depicts a perspective view of an alternative version of an endeffector with an angled anvil and an angled cartridge;

FIG. 14 depicts a perspective view of an alternative version of an endeffector with an angled anvil and an angled cartridge;

FIG. 15 depicts a perspective view of an exemplary end effector of asurgical stapler and an exemplary buttress assembly applicator, with theend effector approaching the buttress assembly applicator;

FIG. 16 depicts a perspective view of the end effector and the buttressassembly applicator of FIG. 15, with the buttress assembly applicatorpositioned in the end effector;

FIG. 17A depicts a cross-sectional end view of a portion of the endeffector of FIG. 15 with the buttress assembly of FIG. 15 applied to theend effector, with tissue positioned between the buttresses in the endeffector, and with the anvil in an open position;

FIG. 17B depicts a cross-sectional end view of the combined end effectorand buttress assembly of FIG. 17A, with tissue positioned between thebuttresses in the end effector, and with the anvil in a closed position;

FIG. 17C depicts a cross-sectional view of a staple and the buttressassembly of FIG. 17A having been secured to the tissue by the endeffector of FIG. 15;

FIG. 18 depicts a perspective view of staples and the buttress assemblyof FIG. 17A having been secured to the tissue by the end effector ofFIG. 15;

FIG. 19 depicts a perspective view of an exemplary buttress assemblyapplicator that includes an example of a buttress assembly applicatorcarrying an example of a buttress assembly for an upper jaw and anexample of another buttress assembly for a lower jaw;

FIG. 20 depicts an exploded perspective view of the buttress assemblyapplicator of FIG. 19 including a chassis and a platform in addition toa pair of buttress assemblies;

FIG. 21 depicts a front perspective view of the chassis of FIG. 20;

FIG. 22 depicts a front perspective view of the platform of FIG. 20;

FIG. 23 depicts a rear perspective view of the platform of FIG. 20;

FIG. 24 depicts an elevational side view of the platform of FIG. 20;

FIG. 25 depicts a top perspective view of a left actuator sled of thebuttress assembly applicator of FIG. 20;

FIG. 26 depicts a bottom perspective view of the left actuator sled ofFIG. 25;

FIG. 27 depicts a top perspective view of a right actuator sled of thebuttress assembly applicator of FIG. 20;

FIG. 28 depicts a bottom perspective view of the right actuator sled ofFIG. 27;

FIG. 29 depicts a perspective view of the chassis and the platform ofFIG. 21 and

FIG. 22 with pairs of left and right actuator sleds of FIG. 25 and FIG.27;

FIG. 30 depicts a cross-sectional view of the chassis, the platform, andthe actuator sleds of FIG. 29 taken along section line 30-30 of FIG. 29;

FIG. 31 depicts a top view of the chassis, the platform, and theactuator sleds of FIG. 29 in a restraint position;

FIG. 32 depicts the top view of the chassis, the platform, and theactuator sleds similar to FIG. 31, but showing the actuator sleds beingdirected from the restraint position toward a release position;

FIG. 33 depicts the top view of the chassis, the platform, and theactuator sleds similar to FIG. 32, but showing the actuator sleds in therelease position;

FIG. 34 depicts a top view of an exemplary end effector of a surgicalinstrument showing the buttress assembly applicator of FIG. 19positioned between the upper and lower jaws of the end effector in aclosed position;

FIG. 35 depicts a bottom view of the end effector of FIG. 34, showingthe buttress assembly applicator of FIG. 19 positioned between the upperand lower jaws of the end effector in a closed position;

FIG. 36 depicts a top view of an exemplary end effector of a surgicalinstrument showing the buttress assembly applicator of FIG. 19positioned between the upper and lower jaws of the end effector in aclosed position;

FIG. 37 depicts a side elevation view of the end effector of FIG. 36,showing the buttress assembly applicator of FIG. 19 in cross-section andpositioned between the upper and lower jaws of the end effector in aclosed position;

FIG. 38 depicts a top view of another exemplary buttress assemblyapplicator carrying one or more exemplary buttress assemblies forapplying to an end effector of a surgical stapler;

FIG. 39 depicts a top view of the buttress assembly applicator of FIG.38, shown with an end effector positioned within a channel or spacedefined by the buttress assembly applicator prior to clamping;

FIG. 40 depicts a side elevation view of the buttress assemblyapplicator and end effector of FIG. 39, shown with the end effectorpositioned but not clamped;

FIG. 41 depicts a side elevation view of the buttress assemblyapplicator and end effector of FIG. 39, shown with the end effectorpositioned and in a clamped state;

FIG. 42 depicts a perspective view of the buttress assembly applicatorof FIG. 38, shown with the housing assembly removed and with analternate straight tip end effector positioned in an open state over theplatform retaining the buttress assemblies; and

FIG. 43 depicts an enlarged perspective view of a proximal portion ofthe combined buttress assembly applicator and end effector of FIG. 42.

The drawings are not intended to be limiting in any way, and it iscontemplated that various embodiments of the invention may be carriedout in a variety of other ways, including those not necessarily depictedin the drawings. The accompanying drawings incorporated in and forming apart of the specification illustrate several aspects of the presentinvention, and together with the description serve to explain theprinciples of the invention; it being understood, however, that thisinvention is not limited to the precise arrangements shown.

DETAILED DESCRIPTION

The following description of certain examples of the invention shouldnot be used to limit the scope of the present invention. Other examples,features, aspects, embodiments, and advantages of the invention willbecome apparent to those skilled in the art from the followingdescription, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsshould be regarded as illustrative in nature and not restrictive.

It is further understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Thefollowing-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

For clarity of disclosure, the terms “proximal” and “distal” are definedherein relative to a human or robotic operator of the surgicalinstrument. The term “proximal” refers the position of an element closerto the human or robotic operator of the surgical instrument and furtheraway from the surgical end effector of the surgical instrument. The term“distal” refers to the position of an element closer to the surgical endeffector of the surgical instrument and further away from the human orrobotic operator of the surgical instrument. In addition, the terms“upper,” “lower,” “lateral,” “transverse,” “bottom,” “top,” are relativeterms to provide additional clarity to the figure descriptions providedbelow. The terms “upper,” “lower,” “lateral,” “transverse,” “bottom,”“top,” are thus not intended to unnecessarily limit the inventiondescribed herein.

In addition, the terms “first” and “second” are used herein todistinguish one or more portions of the surgical instrument. Forexample, a first assembly and a second assembly may be alternatively andrespectively described as a second assembly and a first assembly. Theterms “first” and “second” and other numerical designations are merelyexemplary of such terminology and are not intended to unnecessarilylimit the invention described herein.

I. EXEMPLARY SURGICAL STAPLER

FIGS. 1-7 depict an exemplary surgical stapling and severing instrument(10) that is sized for insertion, in a nonarticulated state as depictedin FIG. 1, through a trocar cannula to a surgical site in a patient forperforming a surgical procedure. By way of example only, such a trocarmay be inserted in a patient's abdomen, between two of the patient'sribs, or elsewhere. In some settings, instrument (10) is used without atrocar. For instance, instrument (10) may be inserted directly through athoracotomy or other type of incision. Instrument (10) of the presentexample includes a handle portion (20) connected to a shaft (22). Shaft(22) distally terminates in an articulation joint (11), which is furthercoupled with an end effector (12). It should be understood that termssuch as “proximal” and “distal” are used herein with reference to aclinician gripping handle portion (20) of instrument (10). Thus, endeffector (12) is distal with respect to the more proximal handle portion(20). It will be further appreciated that for convenience and clarity,spatial terms such as “vertical,” “horizontal,” “upper,” and “lower” areused herein with respect to the drawings. However, surgical instrumentsare used in many orientations and positions, and these terms are notintended to be limiting and absolute.

In some versions, shaft (22) is constructed in accordance with at leastsome of the teachings of U.S. Pat. No. 9,795,379, entitled “SurgicalInstrument with Multi-Diameter Shaft,” issued Oct. 24, 2017, thedisclosure of which is incorporated by reference herein. Other suitableconfigurations for shaft (22) will be apparent to those of ordinaryskill in the art in view of the teachings herein.

Once articulation joint (11) and end effector (12) are inserted throughthe cannula passageway of a trocar, articulation joint (11) may beremotely articulated, as depicted in phantom in FIG. 1, by anarticulation control (13), such that end effector (12) may be deflectedfrom the longitudinal axis (LA) of shaft (22) at a desired angle (a).End effector (12) may thereby reach behind an organ or approach tissuefrom a desired angle or for other reasons. In some versions,articulation joint (11) enables deflection of end effector (12) along asingle plane. In some other versions, articulation joint (11) enablesdeflection of end effector along more than one plane. Articulation joint(11) and articulation control (13) may be configured in accordance withthe teachings of any of the numerous references that are cited herein.Alternatively, articulation joint (11) and/or articulation control (13)may have any other suitable configuration. By way of example only,articulation control (13) may instead be configured as a knob thatrotates about an axis that is perpendicular to the longitudinal axis(LA) of shaft (22).

In some versions, articulation joint (11) and/or articulation control(13) are/is constructed and operable in accordance with at least some ofthe teachings of U.S. Pat. No. 9,186,142, entitled “Surgical InstrumentEnd Effector Articulation Drive with Pinion and Opposing Racks,” issuedon Nov. 17, 2015, the disclosure of which is incorporated by referenceherein. Articulation joint (11) may also be constructed and operable inaccordance with at least some of the teachings of U.S. Pat. No.9,795,379, entitled “Surgical Instrument with Multi-Diameter Shaft,”issued Oct. 24, 2017, the disclosure of which is incorporated byreference herein. Other suitable forms that articulation joint (11) andarticulation control (13) may take will be apparent to those of ordinaryskill in the art in view of the teachings herein.

End effector (12) of the present example includes a lower jaw (16) and apivotable anvil (18). In the present example, anvil (18) can also beconsidered an upper jaw. Furthermore, in some versions like the presentexample, the upper jaw or anvil (18) pivots with respect to a stationarylower jaw (16); however, in some other versions the upper jaw or anvil(18) is stationary while the lower jaw (16) pivots. In some versions,lower jaw (16) is constructed in accordance with at least some of theteachings of U.S. Pat. No. 9,808,248, entitled “Installation Featuresfor Surgical Instrument End Effector Cartridge,” issued Nov. 7, 2017,the disclosure of which is incorporated by reference herein. Anvil (18)may be constructed in accordance with at least some of the teachings ofU.S. Pat. No. 9,517,065, entitled “Integrated Tissue Positioning and JawAlignment Features for Surgical Stapler,” issued Dec. 13, 2016, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.9,839,421, entitled “Jaw Closure Feature for End Effector of SurgicalInstrument,” issued Dec. 12, 2017, the disclosure of which isincorporated by reference herein; and/or at least some of the teachingsof U.S. Pat. No. 10,092,292, entitled “Staple Forming Features forSurgical Stapling Instrument,” issued Oct. 9, 2018, the disclosure ofwhich is incorporated by reference herein. Other suitable forms thatlower jaw (16) and anvil (18) may take will be apparent to those ofordinary skill in the art in view of the teachings herein.

Handle portion (20) includes a pistol grip (24) and a closure trigger(26). Closure trigger (26) is pivotable toward pistol grip (24) to causeclamping, or closing, of the anvil (18) toward lower jaw (16) of endeffector (12). Such closing of anvil (18) is provided through a closuretube (32) and a closure ring (33), which both longitudinally translaterelative to handle portion (20) in response to pivoting of closuretrigger (26) relative to pistol grip (24). Closure tube (32) extendsalong the length of shaft (22); and closure ring (33) is positioneddistal to articulation joint (11). Articulation joint (11) is operableto communicate/transmit longitudinal movement from closure tube (32) toclosure ring (33).

Handle portion (20) also includes a firing trigger (28). An elongatemember (not shown) longitudinally extends through shaft (22) andcommunicates a longitudinal firing motion from handle portion (20) to afiring beam (14) in response to actuation of firing trigger (28). Thisdistal translation of firing beam (14) causes the stapling and severingof clamped tissue in end effector (12), as will be described in greaterdetail below. Thereafter, triggers (26, 28) may be released to releasethe tissue from end effector (12).

FIGS. 3-6 depict end effector (12) employing an E-beam form of firingbeam (14) to perform a number of functions. It should be understood thatan E-beam form is just a merely illustrative example. Firing beam (14)may take any other suitable form, including but not limited tonon-E-beam forms. As best seen in FIGS. 4A-4B, firing beam (14) includesa transversely oriented upper pin (38), a firing beam cap (44), atransversely oriented middle pin (46), and a distally presented cuttingedge (48). Upper pin (38) is positioned and translatable within alongitudinal anvil slot (42) of anvil (18). Firing beam cap (44)slidably engages a lower surface of lower jaw (16) by having firing beam(14) extend through lower jaw slot (45) (shown in FIG. 4B) that isformed through lower jaw (16). Middle pin (46) slidingly engages a topsurface of lower jaw (16), cooperating with firing beam cap (44).Thereby, firing beam (14) affirmatively spaces end effector (12) duringfiring.

Some non-E-beam forms of firing beam (14) may lack upper pin (38),middle pin (46) and/or firing beam cap (44). Some such versions ofinstrument (10) may simply rely on closure ring (33) or some otherfeature to pivot anvil (18) to a closed position and hold anvil (18) inthe closed position while firing beam (14) advances to the distalposition. By way of example only, firing beam (14) and/or associatedlockout features may be constructed and operable in accordance with atleast some of the teachings of U.S. Pat. No. 9,717,497, entitled“Lockout Feature for Movable Cutting Member of Surgical Instrument,”issued Aug. 1, 2017, the disclosure of which is incorporated byreference herein. Other suitable forms that firing beam (14) may takewill be apparent to those of ordinary skill in the art in view of theteachings herein.

FIG. 3 shows firing beam (14) of the present example proximallypositioned and anvil (18) pivoted to an open position, allowing anunspent staple cartridge (37) to be removably installed into a channelof lower jaw (16). As best seen in FIGS. 5-6, staple cartridge (37) ofthis example includes a cartridge body (70), which presents an upperdeck (72) and is coupled with a lower cartridge tray (74). As best seenin FIG. 3, a vertical slot (49) is formed through part of staplecartridge (37). As also best seen in FIG. 3, three rows of stapleapertures (51) are formed through upper deck (72) on one side ofvertical slot (49), with another set of three rows of staple apertures(51) being formed through upper deck (72) on the other side of verticalslot (49). Of course, any other suitable number of staple rows (e.g.,two rows, four rows, any other number) may be provided. Referring backto FIGS. 4A-6, a wedge sled (41) and a plurality of staple drivers (43)are captured between cartridge body (70) and tray (74), with wedge sled(41) being located proximal to staple drivers (43). Wedge sled (41) ismovable longitudinally within staple cartridge (37); while stapledrivers (43) are movable vertically within staple cartridge (37).Staples (47) are also positioned within cartridge body (70), abovecorresponding staple drivers (43). In particular, each staple (47) isdriven vertically within cartridge body (70) by a staple driver (43) todrive staple (47) out through an associated staple aperture (51). Asbest seen in FIGS. 4A-4B and 6, wedge sled (41) presents inclined camsurfaces that urge staple drivers (43) upwardly as wedge sled (41) isdriven distally through staple cartridge (37).

In some versions, staple cartridge (37) is constructed and operable inaccordance with at least some of the teachings of U.S. Pat. No.9,517,065, entitled “Integrated Tissue Positioning and Jaw AlignmentFeatures for Surgical Stapler,” issued Dec. 13, 2016, the disclosure ofwhich is incorporated by reference herein. In addition or in thealternative, staple cartridge (37) may be constructed and operable inaccordance with at least some of the teachings of U.S. Pat. No.9,808,248, entitled “Installation Features for Surgical Instrument EndEffector Cartridge,” issued Nov. 7, 2017, the disclosure of which isincorporated by reference herein. Other suitable forms that staplecartridge (37) may take will be apparent to those of ordinary skill inthe art in view of the teachings herein.

With end effector (12) closed as depicted in FIGS. 4A-4B by distallyadvancing closure tube (32) and closure ring (33), firing beam (14) isthen advanced in engagement with anvil (18) by having upper pin (38)enter longitudinal anvil slot (42). A pusher block (80) (shown in FIG.5) is located at the distal end of firing beam (14) and is configured toengage wedge sled (41) such that wedge sled (41) is pushed distally bypusher block (80) as firing beam (14) is advanced distally throughstaple cartridge (37) when firing trigger (28) is actuated. During suchfiring, cutting edge (48) of firing beam (14) enters vertical slot (49)of staple cartridge (37), severing tissue clamped between staplecartridge (37) and anvil (18). As shown in FIGS. 4A-4B, middle pin (46)and pusher block (80) together actuate staple cartridge (37) by enteringinto vertical slot (49) within staple cartridge (37), driving wedge sled(41) into upward camming contact with staple drivers (43) that in turndrive staples (47) out through staple apertures (51) and into formingcontact with staple forming pockets (53) (shown in FIG. 3) on the innersurface of anvil (18). FIG. 4B depicts firing beam (14) fully distallytranslated after completing severing and stapling of tissue. It shouldbe understood that staple forming pockets (53) are intentionally omittedfrom the view in FIGS. 4A-4B; but staple forming pockets (53) are shownin FIG. 3. It should also be understood that anvil (18) is intentionallyomitted from the view in FIG. 5.

FIG. 7 shows end effector (12) having been actuated through a singlestroke through tissue (90). As shown, cutting edge (48) (obscured inFIG. 7) has cut through tissue (90), while staple drivers (43) havedriven three alternating rows of staples (47) through the tissue (90) oneach side of the cut line produced by cutting edge (48). Staples (47)are all oriented substantially parallel to the cut line in this example,though it should be understood that staples (47) may be positioned atany suitable orientations. In the present example, end effector (12) iswithdrawn from the trocar after the first stroke is complete, spentstaple cartridge (37) is replaced with a new staple cartridge, and endeffector (12) is then again inserted through the trocar to reach thestapling site for further cutting and stapling. This process may berepeated until the desired number of cuts and staples (47) have beenprovided. Anvil (18) may need to be closed to facilitate insertion andwithdrawal through the trocar; and anvil (18) may need to be opened tofacilitate replacement of staple cartridge (37).

It should be understood that cutting edge (48) may sever tissuesubstantially contemporaneously with staples (47) being driven throughtissue during each actuation stroke. In the present example, cuttingedge (48) just slightly lags behind driving of staples (47), such that astaple (47) is driven through the tissue just before cutting edge (48)passes through the same region of tissue, though it should be understoodthat this order may be reversed or that cutting edge (48) may bedirectly synchronized with adjacent staples. While FIG. 7 shows endeffector (12) being actuated in two layers (92, 94) of tissue (90), itshould be understood that end effector (12) may be actuated through asingle layer of tissue (90) or more than two layers (92, 94) of tissue.It should also be understood that the formation and positioning ofstaples (47) adjacent to the cut line produced by cutting edge (48) maysubstantially seal the tissue at the cut line, thereby reducing orpreventing bleeding and/or leaking of other bodily fluids at the cutline. Furthermore, while FIG. 7 shows end effector (12) being actuatedin two substantially flat, apposed planar layers (92, 94) of tissue, itshould be understood that end effector (12) may also be actuated acrossa tubular structure such as a blood vessel, a section of thegastrointestinal tract, etc. FIG. 7 should therefore not be viewed asdemonstrating any limitation on the contemplated uses for end effector(12). Various suitable settings and procedures in which instrument (10)may be used will be apparent to those of ordinary skill in the art inview of the teachings herein.

In one version, instrument (10) provides motorized control of firingbeam (14). Exemplary components that may be used to provide motorizedcontrol of firing beam (14) are shown and described in U.S. Pat. No.9,622,746, entitled “Distal Tip Features for End Effector of SurgicalInstrument,” issued Apr. 18, 2017, the disclosure of which isincorporated by reference herein. In addition to or in lieu of theforegoing, at least part of the motorized control may be configured inaccordance with at least some of the teachings of U.S. Pat. No.8,210,411, entitled “Motor-Driven Surgical Instrument,” issued Jul. 3,2012, the disclosure of which is incorporated by reference herein. Inaddition to or in lieu of the foregoing, the features operable to drivefiring beam (14) may be configured in accordance with at least some ofthe teachings of U.S. Pat. No. 8,453,914, the disclosure of which isincorporated by reference herein; and/or in accordance with at leastsome of the teachings of U.S. Pat. No. 8,453,914, the disclosure ofwhich is also incorporated by reference herein. Other suitablecomponents, features, and configurations for providing motorization offiring beam (14) will be apparent to those of ordinary skill in the artin view of the teachings herein. It should also be understood that someother versions may provide manual driving of firing beam (14), such thata motor may be omitted. By way of example only, firing beam (14) may beactuated in accordance with at least some of the teachings of any otherpatent/publication reference cited herein.

Instrument (10) may also include a lockout switch and lockout indicatoras shown and described in U.S. Pat. No. 9,622,746, entitled “Distal TipFeatures for End Effector of Surgical Instrument,” issued Apr. 18, 2017,the disclosure of which is incorporated by reference herein.Additionally, a lockout switch and/or lockout indication and associatedcomponents/functionality may be configured in accordance with at leastsome of the teachings of U.S. Pat. No. 7,644,848, entitled “ElectronicLockouts and Surgical Instrument Including Same,” issued Jan. 12, 2010,the disclosure of which is incorporated by reference herein.

Instrument (10) also include a manual return switch (116) configured toact as a “bailout” feature, enabling the operator to quickly beginretracting firing beam (14) proximally during a firing stroke. In otherwords, manual return switch (116) may be manually actuated when firingbeam (14) has only been partially advanced distally. Manual returnswitch (116) may provide further functionality in accordance with atleast some of the teachings of U.S. Pat. No. 9,622,746, entitled “DistalTip Features for End Effector of Surgical Instrument,” issued Apr. 18,2017, the disclosure of which is incorporated by reference herein.

In describing the operation of instrument (10), use of the term “pivot”(and similar terms with “pivot” as a base) should not be read asnecessarily requiring pivotal movement about a fixed axis. In someversions, anvil (18) pivots about an axis that is defined by a pin (orsimilar feature) that slides along an elongate slot or channel as anvil(18) moves toward lower jaw (16). In such versions, the pivot axistranslates along the path defined by the slot or channel while anvil(18) simultaneously pivots about that axis. In addition or in thealternative, the pivot axis may slide along the slot/channel first, withanvil (18) then pivoting about the pivot axis after the pivot axis hasslid a certain distance along the slot/channel. It should be understoodthat such sliding/translating pivotal movement is encompassed withinterms such as “pivot,” “pivots,” “pivotal,” “pivotable,” “pivoting,” andthe like. Of course, some versions may provide pivotal movement of anvil(18) about an axis that remains fixed and does not translate within aslot or channel, etc.

It should be understood that instrument (10) may be configured andoperable in accordance with any of the teachings of U.S. Pat. Nos.4,805,823; 5,415,334; 5,465,895; 5,597,107; 5,632,432; 5,673,840;5,704,534; 5,814,055; 6,978,921; 7,000,818; 7,143,923; 7,303,108;7,367,485; 7,380,695; 7,380,696; 7,404,508; 7,434,715; 7,721,930;8,408,439; and/or 8,453,914. As noted above, the disclosures of each ofthose patents and publications are incorporated by reference herein.Additional exemplary modifications that may be provided for instrument(10) will be described in greater detail below. Various suitable ways inwhich the below teachings may be incorporated into instrument (10) willbe apparent to those of ordinary skill in the art. Similarly, varioussuitable ways in which the below teachings may be combined with variousteachings of the patents/publications cited herein will be apparent tothose of ordinary skill in the art. It should also be understood thatthe below teachings are not limited to instrument (10) or devices taughtin the patents cited herein. The below teachings may be readily appliedto various other kinds of instruments, including instruments that wouldnot be classified as surgical staplers. Various other suitable devicesand settings in which the below teachings may be applied will beapparent to those of ordinary skill in the art in view of the teachingsherein.

II. EXEMPLARY END EFFECTOR WITH VISUALIZATION, LEAD-IN, AND GATHERINGFEATURE

In some instances, it may be desirable to provide the user with bettervisualization of end effector (12). In particular, as end effector (12)is inserted into a surgical site, the user may rotate shaft (22) ofinstrument (10) during the procedure. As a result, end effector (12)also rotates. As end effector (12) rotates, it may be desirable for theuser to have visual access to the surgical site. For instance, the usermay wish to see the interface or contact between tissue (90) and endeffector (12). Since end effector (12) may be rotated about thelongitudinal axis (LA) relative to handle portion (20), the user mayview the surgical site such that lower jaw (16) of end effector isvisible rather than anvil (18). Alternatively, end effector (12) couldbe rotated such that when the user views end effector (12), anvil (18)is visible by the user. It may be desirable to provide visibility of thesurgical site for the user beyond what is possible in instrument (10) ofFIG. 1. For instance, in the case of some surgical procedures wherefluid carrying vessels are transected and stapled, it may be desirableto have visual confirmation that anvil (18) and lower jaw (16)completely cover the vessel to be cut, such that the vessel may be fullycut and stapled in one single actuation. In other words, the user maywish to avoid cutting and stapling only a portion of a vessel. Thus,some means of visual monitoring and/or feedback may be desirable so thatthe user will know that end effector (12) has been positioned properlywithin the surgical site for anvil (18) and lower jaw (16) to fullyclamp the vessel. One potential way of monitoring the surgical site mayinclude improving visualization of the area adjacent to the distal tipof lower jaw (16) and anvil (18). Furthermore, not only visualization ofthe distal end of end effector (12) may be desirable, but also it may bedesirable to construct end effector (12) such that the distal end ofanvil (18) is configured to urge tissue (e.g., a large vessel)proximally into the space between anvil (18) and lower jaw (16) as anvil(18) closes toward lower jaw (16).

FIG. 8 depicts an exemplary end effector (212) comprising an anvil (218)and a lower jaw (216). It will be appreciated that end effector (212)may be used in place of end effector (12) of instrument (10). Endeffector (212) may be integrally formed with instrument (10) or in thealternative may be interchangeable with end effector (12) of instrument(10).

Anvil (218) is operable to pivot relative to lower jaw (216). Anvil(218) and lower jaw (216) may clamp tissue (90) similarly to clampingperformed by anvil (18) and lower jaw (16) shown in FIG. 1. End effector(212) further comprises a cartridge (237) operable to be placed in lowerjaw (216) similarly to cartridge (37) shown in FIG. 3.

Anvil (218) as can be seen in FIGS. 8-10 has an elongated shape wherethe distal portion of anvil (218) angles toward cartridge (237). Thedistal portion of anvil (218) angles toward cartridge (237) such thatthe distal most tip (219) of anvil (218) extends distally longitudinallyfurther than cartridge (237). Though in some versions, distal tip (219)may extend to a distance longitudinally equal to cartridge (237) orproximal relative to the distal most point on cartridge (237).Furthermore, anvil (218) angles toward cartridge (237) through a gentleslope. As seen best in FIG. 10, anvil (218) includes sides (241) thattaper as they approach the distal most tip (219) of anvil (218). By wayof example, anvil (218) is shaped in FIG. 8 similarly to an inverted skitip. The angled shape of anvil (218) may provide easier insertion of endeffector (212) into a surgical site. For instance, the gentle slope orinverted ski tip shape of anvil (218) may provide an atraumatic tissuedeflection surface as anvil (218) contacts or moves through tissue. Suchatraumatic tissue deflection may include urging tissue (e.g., a largevessel) proximally into the space between anvil (218) and lower jaw(216) as anvil (218) closes toward lower jaw (216). Once placed into asurgical site, the angled shape of anvil (218) may also provide bettermaneuverability of end effector (212) and better visibility of thedistal end of end effector (212) in relation to anatomical structures atthe surgical site. Other suitable variations of anvil (218) will beapparent to one of ordinary skill in the art in view of the teachingsherein.

Cartridge (237) is operable to hold staples similar to staples (47)shown in FIG. 4A for driving into tissue. As shown in FIG. 9, the distalend of cartridge (237) has a triangular profile. In particular, thedistal end of cartridge (237) comprises an upper tapered surface (239)and a lower tapered surface (238). Additionally, the distal end ofcartridge (237) comprises a tapered side surface (243) on each side. Inthe present example, each tapered side surface (243) of cartridge (237)generally aligns with the taper presented by sides (241) of anvil (218).Thus, as shown in FIG. 10, side surfaces (243) of cartridge (237) do notextend outwardly from longitudinal axis (LA) of end effector (212) pastsides (241) of anvil (218). Upper tapered surface (239) and lowertapered surface (238) lead to the distal most end of cartridge (237).Lower tapered surface (238) defines a sight line (240) such that onceend effector (212) is inserted into a surgical site, the user can seealong sight line (240). Sight line (240) extends along the edge of lowertapered surface (238). It will be appreciated that the planar shape oflower tapered surface (238) may be operable to allow the user tovisualize and/or nearly visualize the distal tip (219) of anvil (218).In particular, sight line (240) intersects longitudinal axis (LA), whichextends longitudinally through end effector (212), to form a viewingangle (θ).

Viewing angle (θ) may establish the relative visibility that a user hasregarding distal tip (219). In particular, the user can see in front ofdistal tip (219) along any line of sight that passes through theintersection of sight line (240) and longitudinal axis (LA) withinviewing angle (θ). For instance, as viewing angle (θ) increases, theuser would have greater visibility of the area immediately in front ofdistal tip (219) from proximal vantage points; whereas as viewing angle(θ) decreases, the user has less visibility of the area in front ofdistal tip (219) from proximal vantage points. In some versions, viewingangle (θ) defines an angle greater than 90 degrees. Additionally, insome versions, viewing angle (θ) defines an angle greater than 135degrees. Other suitable angles for viewing angle (θ) will be apparent toone of ordinary skill in the art in view of the teachings herein. In theillustrated version, the user generally looks along sight line (240) oralong some other line of sight within viewing angle (θ), thus, the userhas visibility along sight line as well as any area within viewing angle(θ). The underside of distal tip (219) is further slightly rounded toaid in the visibility of the intersection of longitudinal axis (LA) andsight line (240).

When tissue (90) is clamped between a closed cartridge (237) and anvil(218), the user can look along sight line (240) or elsewhere withinviewing angle (θ) to see, for instance, precisely where anvil (218) hasclamped tissue (90). Furthermore, the user would be able to determinewhether the tissue is completely clamped between anvil (218) andcartridge (237) such that tissue does not spill over the end of endeffector (212). The user may be able to also visualize the quality ofthe clamp between anvil (218) and cartridge (237) against tissue (90).It will be appreciated that in some instances, end effector (212) may berotated before, during, or after clamping tissue (90). As a result, thetapered shape of anvil (218) may also provide more accessible viewing ofdistal tip (219) or substantially adjacent distal tip (219). The taperof anvil (218) along with lower tapered surface (238) of cartridge (237)may further promote easy insertion of end effector (212) into tissue inan atraumatic manner. Furthermore, it may be easier to fit end effector(212) through a trocar or other devices operable to introduce endeffector (212) into a surgical site due to the tapered end of endeffector (212). For instance, once distal tip (219) is fit into atrocar, lower tapered surface (238) and the tapered shape of anvil (218)may provide a lead-in, guiding the rest of end effector (212) into thetrocar. In view of the teachings herein, those of ordinary skill in theart will further appreciate that visibility and maneuverability can beenhanced by the tapered design for both sides (241) of anvil (218) andeach side (243) of cartridge (237).

In addition to the foregoing, end effector (212) and versions ofinstrument (10) incorporating end effector (212) may be configured andoperable in accordance with at least some of the teachings of U.S. Pat.No. 9,186,142, entitled “Surgical Instrument End Effector ArticulationDrive with Pinion and Opposing Racks,” issued Nov. 17, 2015, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.9,717,497, entitled “Lockout Feature for Movable Cutting Member ofSurgical Instrument,” issued Aug. 1, 2017, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 9,517,065, entitled“Integrated Tissue Positioning and Jaw Alignment Features for SurgicalStapler,” issued Dec. 13, 2016, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 9,839,421, entitled “Jaw ClosureFeature for End Effector of Surgical Instrument,” issued Dec. 12, 2017,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 9,622,746, entitled “Distal Tip Features for End Effector ofSurgical Instrument,” issued Apr. 18, 2017, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 10,092,292, entitled“Staple Forming Features for Surgical Stapling Instrument,” issued Oct.9, 20018, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 9,795,379, entitled “Surgical Instrument withMulti-Diameter Shaft,” issued Oct. 24, 2017, the disclosure of which isincorporated by reference herein; and/or U.S. Pat. No. 9,808,248,entitled “Installation Features for Surgical Instrument End EffectorCartridge,” issued Nov. 7, 2017, the disclosure of which is incorporatedby reference herein. Further modifications that may be incorporated intoend effector (212) will be described in greater detail below.

III. EXEMPLARY END EFFECTORS WITH BENT OR ANGLED ELASTICALLY DEFORMABLEANVIL TIPS

In some procedures, it may be necessary to cut along tissue or throughtissue where more than one cutting sequence is necessary to complete theprocedure—in other words making sequential cuts along a continuous path.In such procedures, this sequential cutting technique can be defined as“marching.” With procedures that involve marching, instrument (10) maybe placed at the surgical site, actuated to cut and staple, then removedfrom the surgical site for installing a new cartridge (37), and then beplaced back at the surgical site again for the next cut and staple alongthe same path in which the previous cutting and stapling cycle occurred.This process is repeated until the cut and staple procedure is complete.As can be seen in FIGS. 4A-4B and FIG. 7, the distal end configurationof end effector (12) provides a gap between the distal end of anvil (18)and the distal end of cartridge (37). This gap may facilitate marchingby providing an atraumatic space for tissue to enter the distal end ofend effector (12) at the beginning of each marching step.

As noted above, the distal end configuration of end effector (212) isdifferent from the distal end configuration of end effector (12); withthe different configuration of end effector (212) providing differentpotential advantages. In particular, the distal end configuration of endeffector (212) may provide improved maneuverability and improvedvisibility of the relationship between the distal end of end effector(212) and adjacent anatomical structures. In addition, the distal endconfiguration of end effector (212) may provide tissue-gathering effectsby urging tissue proximally into the space between anvil (218) and lowerjaw (216) as anvil (218) is closed toward lower jaw (216). However, inversions where all the structures of end effector (212) are rigid, thebent configuration of distal tip (219) of anvil (218) may not lenditself well to marching operations, as distal tip (219) may imparttrauma to tissue that is not gathered into the space between anvil (218)and lower jaw (216) as anvil (218) is closed toward lower jaw (216).Thus, in versions where all the structures of end effector (212) arerigid, end effector (212) may be best suited for cutting and staplingoperations (e.g., vessel transection) where all of the tissue that is tobe cut and stapled is gathered proximal to distal tip (219).

In view of the foregoing, it may be desirable to provide a variation ofend effectors (12, 212) that provides the marching capabilities of endeffector (12), the improved visibility associated with end effector(212), and the tissue gathering capabilities of end effector (212),without providing an increased risk of trauma that might otherwise beassociated with fully rigid versions of end effector (212). Thefollowing describes several merely illustrative examples of suchvariations of end effectors (12, 212). In the following examples, ananvil has a distal tip that is resiliently biased to assume a bent orangled configuration like distal tip (219); yet the resiliently biaseddistal tip is deflectable away from the lower jaw in response to asufficient load on the distal tip. It will be understood in view of theteachings herein that providing an anvil with an elastically deformableangled distal tip portion can provide an additional level ofmaneuverability benefits in terms of navigating through tissue to asurgical site. In this manner, the deformable distal tip portion maydeflect or deform to promote smooth and atraumatic movement of the endeffector through tissue, particularly during marching operations.Additionally, with an anvil having a bias to an angled position when notin a loaded state or contacted by surrounding tissue, enhancedvisualization during tissue capture and cutting can be achieved comparedto using end effectors with a straight or non-angled anvil. Moreover, ananvil with a distal tip that is biased to an angled position may providesome degree of tissue gathering effects up until reaching a load pointthat would be associated with marching rather than being associated withsimply gathering a relatively small tissue structure between the anviland lower jaw.

FIG. 11 shows another exemplary instrument (310) configured as asurgical stapler. Instrument (310) comprises a handle portion (320) anda shaft (322). Instrument (310) has a modular configuration such thatshaft (322) is selectively removable from, and attachable to, handleportion (320). Instrument (310) is configured similarly to instrument(10) such that the operability and use of instrument (310) is the sameas described above for instrument (10) with the added feature ofinstrument (310) being a modular configuration. With its modularconfiguration, instrument (310) provides a way to change the endeffector. Such a change in the end effector may be made to replace anotherwise worn end effector, or to provide for a different end effectorconfiguration based on the procedure or user preference. In addition toor in lieu of the foregoing, features operable for providing the modularconfiguration of instrument (310) may be configured in accordance withat least some of the teachings of U.S. Pub. No. 2017/0086823, entitled“Surgical Stapling Instrument with Shaft Release, Powered Firing, andPowered Articulation,” published Mar. 30, 2017, issued as U.S. Pat. No.10,182,813 on Jan. 22, 2019, the disclosure of which is incorporated byreference herein. Other suitable components, features, andconfigurations for providing instrument (310) with a modularconfiguration will be apparent to those of ordinary skill in the art inview of the teachings herein. Moreover, it will be understood by thoseof ordinary skill in the art in view of the teachings herein, thatinstrument (10) may be modified to incorporate a modular configurationas shown and described with respect to instrument (310) or otherinstruments incorporated by reference herein.

In the illustrated example of FIG. 11, instrument (310) comprises an endeffector (312) having an anvil (318) that has an angled distal tip(319). Furthermore, distal tip (319) of anvil (318) is elasticallydeformable. In this manner, and as shown best in FIGS. 12A and 12B,angled distal tip (319) is operable to elastically deform from a firstangled position to a second position. The second position for angleddistal tip (319) may be substantially straight in some versions, but maybe angled to a degree (e.g., slightly above or slightly below thelongitudinal axis (A1) in other versions. It should be understood thatthe second position for angled distal tip (319) may be defined by thecharacteristics (e.g., thickness, density, etc.) of the tissue that isbeing captured between anvil (318) and lower jaw (16). In the presentexample, end effector (312) is provided on shaft (322) that isdetachable from handle portion (320). By way of example only, shaft(322) may be detachable from handle portion (320) in accordance with atleast some of the teachings of U.S. Pat. No. 9,913,642, entitled“Surgical Instrument Comprising a Sensor System,” issued Mar. 13, 2018,the disclosure of which is incorporated by reference herein. In someother versions, shaft (322) is not detachable from handle portion (320).

It will be appreciated that end effector (312) may be used in place ofend effector (12) shown in FIG. 1. In some versions, end effector (312)may be integrally formed with shaft (22) or alternatively may beseparately formed and then combined. In some versions, end effector(312) may be provided for use in robotic systems. In such roboticsystems, modular shaft (322) having end effector (312) may be attachableto a portion of the robotic system for use such that handle portion(320) is replaced by components of the robotic system. Still in otherexamples, end effector (312) may be adapted for use with a roboticsystem in a manner where end effector (312) connects with the roboticsystem without necessarily connecting the entire modular shaft (322). Inview of the teachings herein, other ways to incorporate an end effectorhaving an angled elastically deformable anvil tip into a user operatedor robotic operated instrument will be apparent to those of ordinaryskill in the art.

FIG. 12A shows an enlarged side view of the distal end of end effector(312). End effector (312) comprises anvil (318) and lower jaw (16) thataccepts cartridge (37) as described above with respect to instrument(10). Anvil (318) pivotably rotates toward lower jaw (16) in the samemanner as anvil (18) as described above with respect to instrument (10).In this configuration, end effector (312) is similar to end effector(12), however, anvil (318) comprises angled distal tip (319) that iselastically deformable. As shown in FIG. 12A, tip (319) is imparted witha bias to an angled position that is shown in FIG. 11 and in phantom inFIG. 12A. Tip (319) assumes this angled position when end effector (312)is not clamping tissue and is open, as shown in FIG. 11; or closedwithout clamping tissue, as shown in phantom in FIG. 12A. In instanceswhen end effector (312) is in this angled state or position, endeffector (312) can be considered not loaded or in a non-loaded state orposition. Conversely when end effector (312) is clamping tissue, endeffector (312) can be considered loaded or in a loaded state orposition.

When closed and not clamping tissue between anvil (318) and lower jaw(16), tip (319) contacts cartridge (37). In this position, an undersidesurface (324) of tip (319) defines a plane that intersects alongitudinal axis (A1) defined by shaft (322) to form an angle (θ1).When closed and clamping tissue (90) between anvil (318) and lower jaw(16), underside surface (324) of tip (319) contacts tissue (90). In thisposition, underside surface (324) of tip (319) defines a plane thatintersects longitudinal axis (A1) to form an angle (θ2). In theillustrated example of FIG. 12A, angles (01, 02) are relative tolongitudinal axis (A1), and the sum of angles (01, 02) represent therange of motion distal tip (319) undergoes. By way of example only, andnot limitation, in some examples angle (θ1) is between about 20 andabout 70 degrees, or more particularly between about 30 degrees andabout 50 degrees, in a downward direction from longitudinal axis (A1)toward cartridge (37). By way of example only, and not limitation, insome examples angle (θ2) is between about 0 and about 90 degrees in anupward direction from longitudinal axis (A1) away from cartridge (37).By way of example only, and not limitation, in some examples the rangeof motion undergone by tip (319) is between about 20 degrees and about110 degrees. The angles described for angles (01, 02) are exemplary onlyand not limiting. Other suitable angles will be apparent to those ofordinary skill in the art in view of the teachings herein.

Additionally, in some instances longitudinal axis (A1) represents azero-degree reference and angles relative thereto may be positive ornegative. For instance, where an angle is in a downward direction fromlongitudinal axis (A1) toward cartridge (37), the angle may becharacterized as a negative angle. Similarly, where an angle is in anupward direction from longitudinal axis (A1) away from cartridge (37),the angle may be characterized as a positive angle. When using theseconventions, the range of motion of distal tip (319) due to deformationcan be understood as the sum of the absolute value of the angle whendistal tip (319) is in the position contacting cartridge (37), and theangle when distal tip (319) is in the deformed state when clampingtissue.

FIG. 12B shows another side view of an alternate end effector (412)similar to end effector (312) of FIG. 12A. With end effector (312), whenanvil (318) is in its angled and non-deformed state (as seen in phantomin the view of FIG. 12A), anvil (318) extends to a point even with orproximal to the distal most end of cartridge (37). When anvil (318) isdeformed such that it is deflected upwardly, the end of distal tip (319)extends to a point just distal to the distal most end of cartridge (37).With end effector (412), as shown in FIG. 12B, when anvil (318) is inits angled and non-deformed state (as seen in phantom in the view ofFIG. 12B), anvil (318) extends to a point even with or proximal to thedistal most end of cartridge (37). When anvil (318) is deformed suchthat it is deflected upwardly, the end of a distal tip (319) of anvil(318) extends to a point even with or proximal to the distal most end ofcartridge (37). In this manner, anvil (318) of end effector (412)remains even with or proximal to the distal most end of cartridge (37)when anvil (318) is in its angled state or deformed state such thatanvil (318) does not extend past the distal most end of cartridge (37)whether anvil (318) is in its angled and non-deformed state or in itsdeformed state. In some instances, this can be achieved by modifyinganvil (318) such that distal tip (319) of anvil is shortened in length.In other instances, instruments (10, 310) may be modified to provide fora slight proximal retraction of anvil (318) when clamping. In view ofthe teachings herein, other ways to modify end effector (412) as itrelates to control of anvil (318) position, will be apparent to those ofordinary skill in the art.

IV. ADDITIONAL EXEMPLARY END EFFECTORS FOR SURGICAL STAPLERS

FIG. 13 illustrates another exemplary end effector (512) that isconfigured for use with surgical stapling instruments as describedherein. End effector (512) comprises an anvil (518) and a lower jaw(516). It will be appreciated that end effector (512) may be used inplace of end effector (12) of instrument (10). End effector (512) may beintegrally formed with instrument (10) or in the alternative may beinterchangeable with end effector (12) of instrument (10).

Anvil (518) is operable to pivot relative to lower jaw (516). Anvil(518) and lower jaw (516) may clamp tissue (90) similarly to clampingperformed by anvil (18) and lower jaw (16) shown in FIG. 1. End effector(512) further comprises a cartridge (537) operable to be placed in lowerjaw (516) similarly to cartridge (37) shown in FIG. 3.

Anvil (518) has an elongated shape where the distal portion of anvil(518) angles toward cartridge (537), such that anvil (518) comprises acurved tip. The distal portion of anvil (518) angles toward cartridge(537) such that the distal most tip (519) of anvil (518) extendsdistally longitudinally further than cartridge (537). Though in someversions, distal tip (519) may extend to a distance longitudinally equalto cartridge (537) or proximal relative to the distal most point oncartridge (537). Furthermore, distal portion of anvil (518) includessides (541) that taper as they approach the distal most tip (519) ofanvil (518). This shape of anvil (518) may provide easier insertion ofend effector (512) into a surgical site. For instance, the shape ofanvil (518) may provide an atraumatic tissue deflection surface as anvil(518) contacts or moves through tissue. Such atraumatic tissuedeflection may include urging tissue (e.g., a large vessel) proximallyinto the space between anvil (518) and lower jaw (516) as anvil (518)closes toward lower jaw (516). Once placed into a surgical site, theshape of anvil (518) may also provide better maneuverability of endeffector (512) and better visibility of the distal end of end effector(512) in relation to anatomical structures at the surgical site. Othersuitable variations of anvil (518) will be apparent to one of ordinaryskill in the art in view of the teachings herein.

Cartridge (537) is operable to hold staples similar to staples (47)shown in FIG. 4A for driving into tissue. The distal end of cartridge(537) has a sloped profile. In particular, the distal end of cartridge(537) comprises an upper tapered surface (539), which leads to thedistal most end of cartridge (537).

When tissue (90) is clamped between a closed cartridge (537) and anvil(518), the user can look to see where anvil (518) has clamped tissue(90). Furthermore, the user can determine whether the tissue iscompletely clamped between anvil (518) and cartridge (537) such thattissue does not spill over the end of end effector (512). The user maybe able to also visualize the quality of the clamp between anvil (518)and cartridge (537) against tissue (90). It will be appreciated that insome instances, end effector (512) may be rotated before, during, orafter clamping tissue (90). As a result, the shape of anvil (518) mayalso provide more accessible viewing of distal tip (519). The shape ofanvil (518) and cartridge (537) may further promote easy insertion ofend effector (512) into tissue in an atraumatic manner. Furthermore, itmay be easier to fit end effector (512) through a trocar or otherdevices operable to introduce end effector (512) into a surgical sitedue to the tapered end of end effector (512). For instance, once distaltip (519) is fit into a trocar, the shape of anvil (518) may provide alead-in, guiding the rest of end effector (512) into the trocar. In viewof the teachings herein, those of ordinary skill in the art will furtherappreciate that visibility and maneuverability can be enhanced by thetapered design for both sides (541) of the distal portion of anvil(518).

Still referring to FIG. 13, by way of example only, and not limitation,in one example of end effector (512), the curved tip of anvil (518) maybe configured as a dissecting tip for separating tissue. In some suchversions, such dissection of tissue may be accomplished using the curvedtip of anvil (518). In such instances, the curved tip of anvil (518) isa rigid structure without sharp cutting blades or surfaces anddissection occurs by the rigid curved tip separating and/or dissectingtissue that it contacts with sufficient force. In some versions wherethe curved tip of anvil (518) is configured as a dissecting tip, the tipof the dissecting tip terminates between the planes defined by thetissue contacting surface and the bottom surface. Also, the tip of thedissecting tip is spaced from a distal end of the cartridge when the endeffector is in a closed position. In this manner, the curved tip isconfigured as a dissecting tip that can separate and/or dissect tissuewithout requiring engagement or interlocking of the anvil tip with thedistal end of the cartridge. Also in this manner, the curved tip isconfigured as a dissecting tip having a shape such that a user can slidethe tip behind certain tissue to separate and/or dissect the tissue itcontacts when sufficient force is applied. Of course having the curvedtip of anvil (518) configured as a dissecting tip is not required in allversions of anvil (518), and accordingly in other versions curved tip ofanvil (518) can be an atraumatic tip or placement tip not configured tosever tissue as described above.

FIG. 14 illustrates another exemplary end effector (612) that isconfigured for use with surgical stapling instruments as describedherein. End effector (612) comprises an anvil (618) and a lower jaw(616). It will be appreciated that end effector (612) may be used inplace of end effector (12) of instrument (10). End effector (612) may beintegrally formed with instrument (10) or in the alternative may beinterchangeable with end effector (12) of instrument (10).

Anvil (618) is operable to pivot relative to lower jaw (616). Anvil(618) and lower jaw (616) may clamp tissue (90) similarly to clampingperformed by anvil (18) and lower jaw (16) shown in FIG. 1. End effector(612) further comprises a cartridge (637) operable to be placed in lowerjaw (616) similarly to cartridge (37) shown in FIG. 3.

Anvil (618) has an elongated shape where the distal portion of anvil(618) angles toward cartridge (637). The distal portion of anvil (618)angles toward cartridge (637) such that the distal most tip (619) ofanvil (618) extends distally longitudinally further than cartridge(637). Though in some versions, distal tip (619) may extend to adistance longitudinally equal to cartridge (637) or proximal relative tothe distal most point on cartridge (637). Furthermore, distal portion ofanvil (618) includes sides (641) that curve inward as they approach thedistal most tip (619) of anvil (618). This shape of anvil (618) mayprovide easier insertion of end effector (612) into a surgical site. Forinstance, the shape of anvil (618) may provide an atraumatic tissuedeflection surface as anvil (618) contacts or moves through tissue. Suchatraumatic tissue deflection may include urging tissue (e.g., a largevessel) proximally into the space between anvil (618) and lower jaw(616) as anvil (618) closes toward lower jaw (616). Once placed into asurgical site, the shape of anvil (618) may also provide bettermaneuverability of end effector (612) and better visibility of thedistal end of end effector (612) in relation to anatomical structures atthe surgical site. Other suitable variations of anvil (618) will beapparent to one of ordinary skill in the art in view of the teachingsherein.

Cartridge (637) is operable to hold staples similar to staples (47)shown in FIG. 4A for driving into tissue. The distal end of cartridge(637) has a sloped profile. In particular, the distal end of cartridge(637) comprises an upper tapered surface (639), which leads to thedistal most end of cartridge (637).

When tissue (90) is clamped between a closed cartridge (637) and anvil(618), the user can look to see where anvil (618) has clamped tissue(90). Furthermore, the user can determine whether the tissue iscompletely clamped between anvil (618) and cartridge (637) such thattissue does not spill over the end of end effector (612). The user maybe able to also visualize the quality of the clamp between anvil (618)and cartridge (637) against tissue (90). It will be appreciated that insome instances, end effector (612) may be rotated before, during, orafter clamping tissue (90). As a result, the shape of anvil (618) mayalso provide more accessible viewing of distal tip (619). The shape ofanvil (618) and cartridge (637) may further promote easy insertion ofend effector (612) into tissue in an atraumatic manner. Furthermore, itmay be easier to fit end effector (612) through a trocar or otherdevices operable to introduce end effector (612) into a surgical sitedue to the tapered end of end effector (612). For instance, once distaltip (619) is fit into a trocar, the shape of anvil (618) may provide alead-in, guiding the rest of end effector (612) into the trocar. In viewof the teachings herein, those of ordinary skill in the art will furtherappreciate that visibility and maneuverability can be enhanced by thecurved design for both sides (641) of the distal portion of anvil (618).

In addition to the foregoing, end effectors (512, 612) and versions ofinstrument (10) incorporating end effectors (512, 612) may be configuredand operable in accordance with at least some of the teachings of U.S.Pat. No. 9,186,142, entitled “Surgical Instrument End EffectorArticulation Drive with Pinion and Opposing Racks,” issued Nov. 17,2015, the disclosure of which is incorporated by reference herein; U.S.Pat. No. 9,717,497, entitled “Lockout Feature for Movable Cutting Memberof Surgical Instrument,” issued Aug. 1, 2017, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 9,517,065, entitled“Integrated Tissue Positioning and Jaw Alignment Features for SurgicalStapler,” issued Dec. 13, 2016, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 9,839,421, entitled “Jaw ClosureFeature for End Effector of Surgical Instrument,” issued Dec. 12, 2017,the disclosure of which is incorporated by reference herein; U.S. Pat.No. 9,622,746, entitled “Distal Tip Features for End Effector ofSurgical Instrument,” issued Apr. 18, 2017, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 10,092,292, entitled“Staple Forming Features for Surgical Stapling Instrument,” issued Oct.9, 20018, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 9,795,379, entitled “Surgical Instrument withMulti-Diameter Shaft,” issued Oct. 24, 2017, the disclosure of which isincorporated by reference herein; and/or U.S. Pat. No. 9,808,248,entitled “Installation Features for Surgical Instrument End EffectorCartridge,” issued Nov. 7, 2017, the disclosure of which is incorporatedby reference herein. Further modifications that may be incorporated intoend effector (212) will be described in greater detail below.

V. EXEMPLARY BUTTRESS LOADING AND APPLICATION

FIGS. 15 and 16 illustrate an exemplary end effector (40) configured toapply a buttress to a tissue site where a cutting and stapling operationis performed. End effector (40) includes distal end (141) and isconnected with a shaft assembly (30). End effector (40) comprises ananvil (60), a lower jaw (50), and a staple cartridge (170) received bylower jaw (50). It will be appreciated that end effector (40) may beused in place of end effector (12) of instrument (10). End effector (40)may be integrally formed with instrument (10) or in the alternative maybe interchangeable with end effector (12) of instrument (10).

FIGS. 15 and 16 also illustrate an exemplary buttress applicator (200).Buttress applicator (200) is configured to selectively retain buttressassemblies (100, 110). In the present example, buttress assembly (100)is selectively retained on a top side of applicator (200) and buttressassembly (110) is selectively retained on a bottom side of applicator(200). In some other versions, applicator (200) can be configured suchthat only one buttress assembly (100, 110) is selectively retained bybuttress applicator (200).

To use buttress applicator (200) to load end effector (40) with buttressassemblies (100, 110), the operator would first position applicator(200) and end effector (40) such that end effector (40) is aligned withan open end (202) of applicator (200) as shown in FIG. 1. The operatorwould then advance end effector (40) distally (and/or retract applicator(200) proximally) to position buttress assemblies (100, 110) betweenanvil (60) and staple cartridge (170) as shown in FIG. 2. In order toload buttress assemblies (100, 110) on end effector (40), the operatormay simply close end effector (40) by pivoting anvil (60) toward staplecartridge (170). Closure of end effector (40) results in the distal endsof anvil (60) and staple cartridge (170) bearing against retainingfeatures (204) of buttress applicator (200) that are configured toselectively retain buttress assemblies (100, 110) with buttressapplicator (200). This contact deflects such retaining features (204) ofbuttress applicator (200) to thereby permit contact between a surface ofanvil (60) and buttress assembly (100) on one side of buttressapplicator (200), and a surface of staple cartridge (170) and buttressassembly (110) on another side of buttress applicator (200). Buttressassemblies (100, 110) comprise an adhesive on their respective surfacessuch that with end effector (40) clamping on both buttress assemblies(100, 110), buttress assemblies (100, 110) are adhered respectively toan underside of anvil (60) and a deck surface of staple cartridge (170).End effector (40) may then be re-opened (i.e., pivoting anvil (60) awayfrom staple cartridge (170) and pulled away from buttress applicator(200). With retaining features (204) of applicator (200) disengaged frombuttress assemblies (100, 110), end effector (40) may freely pullbuttress assemblies (100, 110) away from buttress applicator (200) asend effector (40) is pulled away from buttress applicator (200). Withbuttress assemblies (100, 110) loaded on end effector (40), end effector(40) may then be used as described further below with reference to FIGS.17A-18.

FIGS. 17A-17C show a sequence where an end effector (40) that has beenloaded with buttress assemblies (100, 110) is actuated to drive staples(190) through two apposed layers of tissue (T₁, T₂), with buttressassemblies (100, 110) being secured to the same layers of tissue (T₁,T₂) by staples (190). In particular, FIG. 3A shows layers of tissue (T₁,T₂) positioned between anvil (60) and staple cartridge (170), with anvil(60) in the open position. As shown, anvil (60) comprises staple formingpockets (64). Buttress assembly (100) is adhered, via adhesive, tounderside (65) of anvil (60); while buttress assembly (110) is adhered,via adhesive, to deck (73) of staple cartridge (170). Layers of tissue(T₁, T₂) are thus interposed between buttress assemblies (100, 110).Next, end effector (40) is closed, which drives anvil (60) to the closedposition as shown in FIG. 17B. At this stage, layers of tissue (T₁, T₂)are compressed between anvil (60) and staple cartridge (170), withbuttress assemblies (100, 110) engaging opposite surfaces of tissuelayers (T₁, T₂). End effector (40) is then actuated, whereby a stapledriver (75) drives staple (190) through buttress assemblies (100, 110)and tissue layers (T₁, T₂). As shown in FIG. 17C, crown (92) of drivenstaple (190) captures and retains buttress assembly (110) against layerof tissue (T₂). Deformed legs (94) of staple (190) capture and retainbuttress assembly (100) against layer of tissue (T₁).

It should be understood that a series of staples (190) will similarlycapture and retain buttress assemblies (100, 110) against layers oftissue (T₁, T₂), thereby securing buttress assemblies (100, 110) totissue (T₁, T₂) as shown in FIG. 18. As end effector (40) is pulled awayfrom tissue (90) after deploying staples (190) and buttress assemblies(100, 110), buttress assemblies (100, 110) disengage end effector, suchthat buttress assemblies (100, 110) remain secured to tissue (T₁, T₂)with staples (190). Buttress assemblies (100, 110) thus providestructural reinforcement to the lines of staples (190). As can also beseen in FIG. 18, a knife member (not shown) passes through end effector(40) and in doing so also cuts through a centerline of buttressassemblies (100, 110), separating each buttress assembly (100, 110) intoa corresponding pair of sections, such that each section remains securedto a respective severed region of tissue (T₁, T₂).

In the foregoing example, buttress assembly (100) is sized to spanacross the full width of underside (65) of anvil (60), such that a knifemember (not shown) cuts through buttress assembly (100) during actuationof end effector (40). In some other examples, buttress assembly (100) isprovided in two separate, laterally spaced apart portions, with oneportion being disposed on underside (65) of anvil (60) on one half ofanvil (60) and another portion being disposed on underside (65) of anvil(60) on the other half of anvil (60). In such versions, the knife member(not shown) does not cut through buttress assembly (100) duringactuation of end effector (40).

Likewise, buttress assembly (110) may be sized to span across the fullwidth of deck (73), such that the knife member (not shown) cuts throughbuttress assembly (110) during actuation of end effector (40).Alternatively, buttress assembly (110) may be provided in two separate,laterally spaced apart portions, with one portion being disposed on deck(73) on one half and another portion being disposed on deck (73) on theother half. In such versions, the knife member (not shown) does not cutthrough buttress assembly (110) during actuation of end effector (40).

In addition to the foregoing, it should also be understood that any ofthe various buttress assemblies described herein may be furtherconstructed and operable in accordance with at least some of theteachings of U.S. Pat. Pub. No. 2016/0278774, entitled “Method ofApplying a Buttress to a Surgical Stapler,” published Sep. 29, 2016,issued as U.S. Pat. No. 10,349,939 on Jul. 16, 2019, the disclosure ofwhich is incorporated by reference herein.

VI. EXEMPLARY BUTTRESS APPLIER CARTRIDGE ASSEMBLY

In some instances, it may be desirable to use an exemplary buttressapplier cartridge assembly (710) as shown in FIG. 19 to equip a surgicalinstrument with a buttress assembly (712) for forming staples in tissuewith a buttress (714). In some instances, buttress applier cartridgeassembly (710) may be referred to as a buttress assembly applicator(710). These terms as used herein should be understood to beinterchangeable. Buttress (714) inhibits the formed staples from pullingthrough the tissue to thereby reduce a risk of tissue tearing at or nearthe site of formed staples. In addition to or as an alternative toproviding structural support and integrity to a line of staples,buttress (714) may provide various other kinds of effects such asspacing or gap-filling, administration of therapeutic agents, and/orother effects. Prior to use with the surgical instrument, one or morebuttress assemblies (712) is releasably retained on a buttress appliercartridge (716), which is configured to deposit one or more buttressassemblies (712) onto an end effector of a surgical instrument asdiscussed below.

FIG. 19 shows buttress applier cartridge assembly (710) including a pairof buttress assemblies (712) releasably retained on buttress appliercartridge (716), which supports and protects buttress assemblies (712)prior to use and further aids with loading buttress assemblies (712) onsurgical instrument (10) (see FIG. 1). Buttress applier cartridge (716)of the present example includes an open end (718) and a closed end(720). Open end (718) is configured to receive an end effector such asany of those end effectors described herein, including but not limitedto end effectors (12, 212, 312, 412, 512, 612). Buttress appliercartridge (716) further includes a housing assembly (724) having anupper housing (726) and a lower housing (728), which each generallydefine a “U” shape to present open end (718). Various components areinterposed between upper and lower housings (726, 728). In particular,these components include a chassis (736) supporting a platform (730),which is also referred to as a compression layer (730).

Platform or compression layer (730) of the present example supportsupper buttress assembly (712) on one side of platform (730) and lowerbuttress assembly (712) on the other side of platform (730). Platform(730) is exposed in recesses that are formed between the prongs of the“U” configuration of upper and lower housings (726, 728). Thus, upperhousing (726) has an upper gap (737) extending to the open end (718)along an upper surface of platform (730), and lower housing (728)similarly has a lower gap (738) extending to the open end (718) alongthe lower surface of platform (730). The location of platform (730) andbuttress assemblies (712) in such recesses may prevent inadvertentcontact between buttress assemblies (712) and other devices in theoperating room. In other words, upper and lower housings (726, 728) mayprovide some degree of physical shielding of buttress assemblies (712)while buttress assemblies are retained on platform (730).

Additional features may be combined as applicable with the followingexample of buttress applier cartridge assembly (710). Such features aredescribed in U.S. Pat. App. No. 16/235,473, entitled “AdhesiveDistribution on Buttress for Surgical Stapler,” filed on Dec. 28, 2018,published as U.S. Pub. No. 2020/0205820 on Jul. 2, 2020; U.S. Pat. No.16/235,488, entitled “Configuration of Buttress for Surgical Stapler,”filed on Dec. 28, 2018, published as U.S. Pub. No. 2020/0205821 on Jul.2, 2020; U.S. Pat. App. No. 16/235,503, entitled “Surgical StaplerButtress with Tissue In-Growth Promotion,” filed on Dec. 28, 2018,published as U.S. Pub. No. 2020/0205822 on Jul. 2, 2020; U.S. Pat. No.16/235,541, entitled “Packaging for Surgical Stapler Buttress,” filed onDec. 28, 2018, published as U.S. Pub. No. 2020/0205824 on Jul. 2, 2020;U.S. Pat. No. 16/235,681, entitled “Curved Tip Surgical Stapler ButtressAssembly Applicator with Compression Layer Pocket Feature,” filed onDec. 28, 2018, published as U.S. Pub. No. 2020/0205807 on Jul. 2, 2020;U.S. Pat. No. 16/235,630, entitled “Curved Tip Surgical Stapler ButtressAssembly Applicator with Opening Feature for Curved Tip Alignment,”filed on Dec. 28, 2018, published as U.S. Pub. No. 2020/0205826 on Jul.2, 2020; U.S. Pat. No. 16/235,617, entitled “Method of ApplyingButtresses to Surgically Cut and Stapled Sites,” filed on Dec. 28, 2018,published as U.S. Pub. No. 2020/0205825 on Jul. 2, 2020; U.S. Pat. No.29/675,168, entitled “Applicator for Surgical Stapler Buttress,” filedon Dec. 28, 2018; U.S. Pat. No. 29/675,170, entitled “Buttress forSurgical Stapler,” filed on Dec. 28, 2018; U.S. Pat. No. 29/675,172,entitled “Tray for Surgical Stapler Buttress Applicator,” filed on Dec.28, 2018; U.S. Pat. App. No. 29/675,197, entitled “Applicator for aSurgical Stapler Buttress,” filed on Dec. 28, 2018; and U.S. Pat. No.29/675,199entitled “Buttress Assembly for a Surgical Stapler,” filed oneven date herewith Dec. 28, 2018, the disclosures of which are herebyincorporated by reference.

A. Exemplary Buttress Assembly

With respect to FIG. 19, upper and lower buttress assemblies (712) arestructurally identical, but for the relative positions of upper andlower buttress assemblies (712) retained on buttress applier cartridge(716). Buttress applier cartridge assembly (710) may thus be used inmore than one orientation with surgical instrument (10) and itsrespective end effectors that may be combined therewith. It will beappreciated that the following description of upper buttress assembly(712) similarly applies to lower buttress assembly (712) but for therespective orientations.

Upper buttress assembly (712) includes buttress (714) and an upperadhesive layer (742). Buttress (714) of the present example moreparticularly has a three-layer, polymer construction including a corelayer sandwiched between two outer layers to be collectively strong yetflexible to support a line of staples. In the present example, corelayer is a polyglactin 910 material, which is manufactured and sold byEthicon, Inc. of Somerville, N.J. as VICRYL, whereas each outer layer isa polydioxanone (PDO) film material. Buttress (714) of the presentexample is formed by laminating core layer between outer layers under apredetermined pressure, a predetermined temperature, and a predeterminetime. Buttress (714) is further mechanically cut to size therebyinhibiting abrasive edges, such as burrs and/or delamination, that coulddamage sensitive tissues. It will be appreciated that alternativemethods of cutting buttresses (714), such as a laser cutting or hotknife cutting, may be similarly used.

By way of further example only, each buttress (714) may comprise one ormore of the following: NEOVEIL absorbable PGA felt by Gunze Limited, ofKyoto, Japan; SEAMGUARD polyglycolic acid: trimethylene carbonate(PGA:TMC) reinforcement material by W.L. Gore & Associates, Inc., ofFlagstaff, Ariz.; PERI-STRIPS DRY with VERITAS Collagen Matrix (PSDV)reinforcement material, by Baxter Healthcare Corporation of Deerfield,Ill.; BIODESIGN biologic graft material by Cook Medical, Bloomington,Ind.; and/or SURGICEL NU-KNIT hemostat material by Ethicon, Inc. ofSomerville, N.J. Still other suitable materials that may be used to formeach buttress (714) will be apparent to those of ordinary skill in theart in view of the teachings herein.

In addition or in the alternative, each buttress (714) may comprise amaterial including, for example, a hemostatic agent such as fibrin toassist in coagulating blood and reduce bleeding at the severed and/orstapled surgical site along tissue. As another merely illustrativeexample, each buttress (714) may comprise other adjuncts or hemostaticagents such as thrombin may be used such that each buttress (714) mayassist to coagulate blood and reduce the amount of bleeding at thesurgical site. Other adjuncts or reagents that may be incorporated intoeach buttress (714) may further include but are not limited to medicalfluid or matrix components. Merely illustrative examples of materialsthat may be used to form each buttress (714), as well as materials thatmay be otherwise incorporated into each buttress (714), are disclosed inU.S. Pub. No. 2016/0278774, entitled “Method of Applying a Buttress to aSurgical Stapler,” published Sep. 29, 2016, issued as U.S. Pat. No.10,349,939 on Jul. 16, 2019, the disclosure of which is incorporated byreference herein. Alternatively, any other suitable materials may beused.

By way of further example only, each buttress (714) may be constructedin accordance with at least some of the teachings of U.S. Pat. No.10,123,798, entitled “Tissue Thickness Compensator Comprising ControlledRelease and Expansion,” issued Nov. 13, 2018, the disclosure of which isincorporated by reference herein; U.S. Pat. Pub. No. 2013/0068816,entitled “Surgical Instrument and Buttress Material,” published Mar. 21,2013, now abandoned, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 9,999,408, entitled “Surgical Instrumentwith Fluid Fillable Buttress,” issued Jun. 19, 2018, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,814,025,entitled “Fibrin Pad Matrix with Suspended Heat Activated Beads ofAdhesive,” issued Aug. 26, 2014, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 8,899,464, entitled “Attachment ofSurgical Staple Buttress to Cartridge,” issued Dec. 2, 2014, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.9,492,170, entitled “Device for Applying Adjunct in EndoscopicProcedure,” issued Nov. 15, 2016, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,998,060, entitled“Resistive Heated Surgical Staple Cartridge with Phase Change Sealant,”issued Apr. 7, 2015, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 9,393,018, entitled “Surgical StapleAssembly with Hemostatic Feature,” issued Jul. 19, 2016, the disclosureof which is incorporated by reference herein; U.S. Pat. No. 9,101,359,entitled “Surgical Staple Cartridge with Self-Dispensing StapleButtress,” issued Aug. 11, 2015, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 9,198,644, entitled “Anvil Cartridgefor Surgical Fastening Device,” issued Dec. 1, 2015, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. Pub. No.2013/0075447, entitled “Adjunct Therapy for Applying Hemostatic Agent,”published Mar. 28, 2013, now abandoned, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 9,211,120, entitled“Tissue Thickness Compensator Comprising a Plurality of Medicaments,”issued Dec. 15, 2015, the disclosure of which is incorporated byreference herein; U.S. Pat. Pub. No. 2015/0351758, entitled “AdjunctMaterials and Methods of Using Same in Surgical Methods for TissueSealing,” published Dec. 10, 2015, issued as U.S. Pat. No. 10,172,611 onJan. 8, 2019, the disclosure of which is incorporated by referenceherein; U.S. Pat. Pub. No. 2017/0049444, entitled “Implantable Layersfor a Surgical Instrument,” published Feb. 23, 2017, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. Pub. No.2017/0055986, entitled “Medicant Eluting Adjuncts and Methods of UsingMedicant Eluting Adjuncts,” published Mar. 2, 2017, issued as U.S. Pat.No. 10,569,071 on Feb. 25, 2020, the disclosure of which is incorporatedby reference herein; U.S. Pat. Pub. No. 2017/0086837, entitled“Compressible Adjunct with Crossing Spacer Fibers,” published Mar. 30,2017, issued as U.S. Pat. No. 10, 433,846 on Oct. 8, 2019, thedisclosure of which is incorporated by reference herein; and/or U.S.Pat. Pub. No. 2017/0086842, entitled “Method for Applying an ImplantableLayer to a Fastener Cartridge,” published Mar. 30, 2017, the disclosureof which is incorporated by reference herein.

Furthermore, buttress (714) is configured to be cut by a knife (notshown) from a proximal portion of buttress (714), along an intermediateportion of buttress (714), and further through a distal portion ofbuttress (714) such that inward edges are adjacent to cut tissue.Buttress (714) further includes a longitudinally extending pre-cut slit(744) configured to receive knife (not shown) and aid in separatinglateral portions of buttress (714) as inward edges form therealong.

Upper adhesive layer (742) is provided on outer layer of buttress (714)in order to adhere buttress (714) within end effectors described herein.Adherence of the buttress (714) can occur through a variety ofmechanisms including but not limited to a pressure sensitive adhesive.In the case of pressure sensitive adhesion, adhesion occurs upon theapplication of at least a predetermined minimum force. In some versions,each adhesive layer (742) includes a pressure sensitive adhesivematerial. Examples of various suitable materials that may be used toform adhesive layers (742) are disclosed in U.S. Pat. Pub. No.2016/0278774, entitled “Method of Applying a Buttress to a SurgicalStapler,” published Sep. 29, 2016, issued as U.S. Pat. No. 10,349,939 onJul. 16, 2019 the disclosure of which is incorporated by referenceherein. Alternatively, any other suitable materials may be used. Asshown in the present example, adhesive layer (742) is applied to form acontinuous outer seal to enhance longevity once applied to an endeffector.

It should be understood that the term “adhesive,” as used herein, mayinclude (but is not limited to) tacky materials and also materials thatare pliable or wax-like and adhere to a complex geometry via deformationand conformance. Some suitable adhesives may provide such pliability toadhere to a complex geometry via deformation and conformance withoutnecessarily providing a high initial tack. In some instances, adhesiveswith lower tackiness may be removed more cleanly from surfaces. Varioussuitable materials that may be used to form adhesive layers (742) willbe apparent to those of ordinary skill in the art in view of theteachings herein.

B. Exemplary Buttress Applier Cartridge

As shown in FIG. 20, buttress applier cartridge (716) includes chassis(736) supporting platform (730) as well as upper and lower housings(726, 728) of housing assembly (724) configured to connect together todefine an interior space (750). An upper left actuator sled (752) and anupper right actuator sled (754) are movably connected to an upper facechassis (736) within interior space (750), while a lower left actuatorsled (752) and a lower right actuator sled (754) are movably connectedto a lower face of chassis (736) within interior space (750). Upperright and left actuator sleds (752, 754) retain upper buttress assembly(712) on platform (730) in a restraint position, but are configured tomove from the restraint position to a release position for depositingthe upper buttress assembly (712) on an end effector, such as any of theend effectors described herein. Similarly, lower right and left actuatorsleds (752, 754) retain lower buttress assembly (712) on platform (730)in the restraint position, but are configured to move from the restraintposition to the release position for depositing the lower buttressassembly (712) on an end effector, such as any of the end effectorsdescribed herein. In the present example, left actuator sled (752) isdistinct from right actuator sled (754) for reasons discussed below ingreater detail. Also, upper and lower right actuator sleds (752) arestructurally identical to each other, and upper and lower left actuatorsleds (754) are structurally identical to each other. Thus, upper andlower actuator sleds (752, 754) are interchangeable in this respect andany discussion contained herein directed to a pair of upper actuatorsleds (752, 754) is similarly applicable to a pair of lower actuatorsleds (752, 754).

Each actuator sled (752, 754) includes a pair of arms (755 a, 755 b)extending laterally inward to selectively and releasably secure buttressassemblies (712) to platform (730). Arms (755 a, 755 b) may also bereferred to as retaining features or retention members, similar to theretaining features (204) described above with respect to applicator(200) in FIGS. 15 and 16. In particular, FIG. 20 show arms (755 a, 755b) positioned such that buttress assemblies (712) are interposed betweenthe free ends of arms (755 a, 755 b) and platform (730). Arms (755 a,755 b) are movable laterally outwardly such that arms (755 a, 755 b)disengage buttress assemblies (712), thereby enabling buttressassemblies (712) to be removed from platform (730). In the presentexample, arms (755 a, 755 b) are configured to bear against buttressassemblies (712) in the restraint position, thereby pinching buttressassemblies (712) against platform (730). Other suitable ways in whicharms (755 a, 755 b) may engage buttress assemblies (712) will beapparent to those of ordinary skill in the art in view of the teachingsherein.

Chassis (736) is configured to cooperate with upper and lower housings(726, 728) to provide a mechanical ground for moving components ofbuttress applier cartridge (716) and provide structural support forcomponents of buttress applier cartridge (716). Chassis (736) furtherincludes integral gripping features (756) that are exposed on oppositesides of housing assembly (724). Gripping features (756) have a surfacegeometry configured to promote an operator's grip of buttress appliercartridge (716) during use of buttress applier cartridge (716). Varioussuitable configurations that may be used for gripping features (756)will be apparent to those of ordinary skill in the art in view of theteachings herein. Similarly, various surface treatments (e.g.,elastomeric material, etc.) that may be applied to gripping features(756) will be apparent to those of ordinary skill in the art in view ofthe teachings herein.

With respect to FIG. 21, platform (730) is connected to and supported bychassis (736) to secure platform (730) relative to upper and lowerhousing (726, 728). In the present example, platform (730) is unitarilyformed and molded to a rigid web portion (758) including a frame (760)and defining a plurality of holes (762, 764, 766) configured providematerial overlap for mold securement. Holes (762, 764, 766) moreparticularly include an upper slot (762) and central slot (764) thatextend through frame (760) as well as a plurality of through holes (766)spaced laterally about slot (762, 764). Frame (760) also extendslaterally across central slot (764) at bridge portions (768) to provideadditional structural rigidity to chassis (736) while providing platform(730) with sufficient clearance for resilient deformation as discussedbelow in greater detail. Thereby, slots (762, 764) and through holes(766) receive a resilient, elastomeric material to form and secure thematerial as platform (730) to chassis (736). While the present platform(730) is molded to chassis (736), it will be appreciated that platform(730) may be alternatively secured to chassis (736), and thus theattachment of platform (730) to chassis (736) is not intended to belimited to the particular rigid web portion (758) and molding asdiscussed herein. Various suitable materials and structuralconfigurations that may be used to form platform (730) will be apparentto those of ordinary skill in the art in view of the teachings herein.

Chassis (736) further includes a plurality of sled clearance holes (770)arranged in a pair of rows on opposing lateral sides of chassis (736).Left and right actuator sleds (752, 754) connect together on opposingsides of chassis (736) through such sled clearance holes (770) to slideinwardly together in connected pairs. Additional details regardingconnection and actuation of left and right actuator sleds (752, 754)will be discussed below in greater detail. However, it will beappreciated that any such hole through chassis (736) to provide forfastening clearance of left and right actuator sleds (752, 754) may beused, and the invention is not intended to be unnecessarily limited tosled clearance holes (70) as discussed herein.

i. Exemplary Varying Stiffness Platform for Supporting ButtressAssemblies

FIGS. 22-24 show one example of platform (730) in additional detail asincluding a pad (772) and perimeter region (774) laterally extendingtherefrom. Perimeter region (774) is positioned in within frame (760)and extends into through holes (766) to secure pad (772) to chassis(736). In some versions, platform (730) is formed of a material thatprovides a high coefficient of friction, thereby reducing any tendencythat buttress assemblies (712) might otherwise have to slide alongcorresponding surfaces of platform (730). For instance, platform (730)may comprise a resilient, elastomeric material, such as silicone, to bemolded to be formed as securement (774) and pad (772). One examplesilicone material is a 30 Durometer, Shore A silicone. To this end, pad(772) is formed with varying stiffness along its longitudinal length tosimultaneously provide sufficient reactionary forces of at least thepredetermined minimum force for adhesion while accommodating aparallel-camber orientation, an over-camber orientation, and anunder-camber orientation of an end effector as discussed below ingreater detail. As used herein, the term “parallel-camber orientation”refers to an upper jaw and a lower jaw of an end effector beingfunctionally parallel to each other. The term “over-camber orientation”refers to an upper jaw of an end effector being over rotated relative alower jaw of an end effector. The term “under-camber orientation” refersto an upper jaw being under rotated relative to a lower jaw of an endeffector.

With respect to FIGS. 22 and 23, a resilient proximal end (778) of pad(772) has a proximal end stiffness and a proximal transverse depth,whereas a resilient distal end (780) of pad (772) has a distal endstiffness and a distal transverse depth. In the present example,proximal end stiffness is generally greater than the distal endstiffness such that initial compression of distal end (780) requiresless compressive force than compression of proximal end (778). Ofcourse, further compression of distal end (780) relative to proximal end(778) may result in distal end stiffness increasing to or even exceedingproximal end stiffness so long as the lesser stiffness of distal end(780) is included therein for accommodating the over-camberedorientation of an end effector.

In addition, distal transverse depth is greater than proximal transversedepth. Thereby, the greater distal transverse depth effectively props upbuttress assembly (712) for improved engagement with an end effector inthe under-camber orientation, but the decreased distal end stiffnessallows for greater compression to accommodate an end effector in theover-camber orientation. Pad (772) of the present example iswedge-shaped having opposing ramp surfaces (782) continuously taperingtogether from the distal end (780) to the proximal end (778) foraccommodating parallel-camber, over-camber, and under-camberorientations along the entire longitudinal length of pad (772). In someexamples, depths and stiffnesses along pad (772) are configured toreceive a full range of over-camber to under-camber orientations basedon determined manufacturing tolerances of an end effector.

Pad (772) shown in FIGS. 22-24 is unitarily formed of a resilientmaterial having a consistent stiffness throughout. Such longitudinallyvarying stiffness discussed above is thus generated by forming aplurality of reliefs, such as channels (784), in at least the distal end(780) to reduce the distal end stiffness relative to the proximal endstiffness. In the present example, channels (784), such as five channels(784) are equally spaced laterally apart from each other andlongitudinally extend from distal end (780) to proximal end (778).Channels (784) further define varying channel depths in the longitudinaldirection along pad (772). More particularly, upper channels (784)extend transversely downward from upper ramp surface (782) to upper basesurface (786), whereas lower channels (784) extend transversely upwardfrom lower ramp surface (782) to lower base surface (786). In turn, aplurality of ribs (788) are defined between channels (784) and similarlyextend from ramp surfaces (782) to base surfaces (786) to supportbuttress assemblies (712) and have varying stiffness from the proximalend (778) to the distal end (780) on each opposing side of pad (772).

ii. Exemplary Restraint Features for Retention of Buttress Assemblies onVarying Stiffness Platform

FIGS. 20 and 25-28 show restraint features, such as left and rightactuator sleds (752, 754) discussed briefly above for releasablysecuring buttress assemblies (712) to platform (730) in the restraintposition. Each of left and right actuator sleds (752, 754) has arms (755a, 755 b) configured to accommodate varying transverse depths along thelongitudinal length of pad (772). More particularly, arms (755 a, 755 b)include a distal arm (755 a) and a proximal arm (755 b) spacedlongitudinally apart from each other and extending laterally inwardtoward platform (730). Each distal arm (755 a) and proximal arm (755 b)of left or right actuator sled (752, 754) transversely extends towardplatform (730) such that each of distal arm (755 a) and proximal arm(755 b) is offset from the other arms (755 a, 755 b) in the transversedirection. Thereby, distal arm (755 a) and proximal arm (755 b) aretransversely spaced from the ramp surface (782) to trace the contour ofthe ramp surface (782).

With respect to FIGS. 25 and 26, upper left actuator sled (752) has alongitudinally extending upper left sled body (790) with distal andproximal arms (755 a, 755 b) laterally extending inward toward theright. Each arm (755 a, 755 b) of left actuator sled (752) has a camsurface (791) configured to receive an end effector thereagainst to urgeleft actuator sled (752) toward the release position. In addition, adowel hole (792) opens downward and is respectively positioned on aportion of upper left sled body (790). A dowel (794) extends downwardfrom left sled body (790) and in longitudinal alignment with outer dowelhole (792). In order to arrest movement of upper left actuator sled(752) in the restraint and release positions, a distal cantilever catch(796) laterally extends to the left from the distal portion of upperleft sled body (790), and a proximal cantilever catch (798) laterallyextends to the left from the proximal portion of upper left sled body(790). Distal and proximal cantilever catches (796, 798) arerespectively portions of distal and proximal detent couplings (800, 802)discussed below in greater detail.

With respect to FIGS. 27 and 28, upper right actuator sled (754) has alongitudinally extending upper right sled body (804) with distal andproximal arms (755 a, 755 b) laterally extending inward toward the left.Each arm (755 a, 755 b) of right actuator sled (754) has a cam surface(805) configured to receive an end effector thereagainst to urge leftactuator sled (752) toward the release position. In addition, a dowelhole (806) opens downward and is positioned on upper right sled body(804). A dowel (808) extends downward from right sled body (804) and ispositioned in longitudinal alignment with inner dowel hole (806). Inorder to arrest movement of upper right actuator sled (754) in therestraint and release positions, another distal cantilever catch (796)laterally extends to the right from the distal portion of upper rightsled body (804), and another proximal cantilever catch (796) laterallyextends to the right from the proximal portion of upper right sled body(804). Again, distal and proximal cantilever catches (796, 798) arerespectively portions of distal and proximal detent couplings (800, 802)discussed below in greater detail.

FIG. 20 and FIGS. 29 and 30 show upper right and left actuator sleds(752, 754) as discussed above in detail as well as lower right and leftactuator sleds (752, 754). As briefly discussed above, the descriptionof upper right and left actuator sleds (752, 754) similarly applies tolower right and left actuator sleds (752, 754) with like features havinglike numbers, but with reversed transverse directions (e.g. lower,upward, etc.). To this end, upper left actuator sled (752) and lowerright actuator sled (754) connect together as outer dowel (808) snapsinto outer dowel hole (792) and inner dowel (794) snaps into inner dowelhole (806) with chassis (736) positioned therebetween. Upper rightactuator sled (754) and lower left actuator sled (752) similarly connecttogether as outer dowel (808) snaps into outer dowel hole (792) andinner dowel (794) snaps into inner dowel hole (806) with chassis (736)positioned therebetween. Each of inner and outer dowels (794, 808)extend through sled clearance holes (770) to slidably connect left andright actuator sleds (752, 754) to chassis (736).

FIG. 30 shows one example of a pair of distal arms (755 a) and a pair ofproximal arms (755 b) respectively having platform (730) positionedtherebetween and tracing opposing ramp surfaces (782). A central plane(810) is shown in FIG. 12 bisecting upper and lower portions of buttressapplier cartridge (716) through a central core of platform (730). Distalarm (755 a) has a distal retention surface (812 a) transversely offsetfrom central plane (810) a relatively greater distance, and proximal arm(755 b) has a proximal retention surface (812 b) transversely offsetfrom central plane (810) a relatively lesser distance. Thereby, greaterand lesser distances of distal and proximal retention surfaces (812 a,812 b) trace ramp surfaces (782) tapering from distal end (780) of pad(772) to proximal end (778) of pad (772). Thus, distal and proximalretention surfaces (812 a, 812 b) are offset in the transverse directionfrom each other and from central plane (810). In the present example,each of distal arm (755 a) and proximal arm (755 b) are transverselyspaced from the ramp surface (782) an equal transverse dimension suchthat arms (755 a, 755 b) equally trace ramp surfaces (782) tapering fromdistal end (780) of pad (772) to proximal end (778) of pad (772).

As shown in FIGS. 31-33, left and right actuator sleds (752, 754) arerespectively urged outward from the restraint position to the releaseposition away from platform to disengage arms (755 a, 755 b) frombuttress assemblies (712) on platform (730) as discussed herein. Moreparticularly, distal and proximal detent couplings (800, 802) releasablyconnect left and right actuator sleds (752, 754) to chassis (736) toarrest movement of left and right actuator sleds (752, 754) in therestraint position and the release position. Distal and proximal detentcouplings (800, 802) include distal and proximal cantilever catches(796, 798) extending from each of left and right actuator sleds (752,754) as discussed briefly above. In addition, distal and proximal detentcouplings (800, 802) respectively further include distal and proximalground cams (814, 816) extending from chassis (736) in respectiveengagement with distal and proximal cantilever catches (796, 798).

In the restraint position shown in FIG. 31, each distal cantilever catch(796) is respectively engaged with each distal ground cam (814), andeach proximal cantilever catch (798) is respectively engaged with eachproximal ground cam (816) to urge left and right actuator sleds (752,754) inward toward the restraint position. Directing left and rightactuator sleds (752, 754) outward from the restraint position toward therelease position as shown in FIG. 32 resiliently deflects distal andproximal cantilever catches (796, 798) as distal and proximal cantilevercatches (796, 798) follow distal and proximal ground cams (814, 816). Asdistal and proximal cantilever catches (796, 798) pass around distal andproximal ground cams (814, 816), distal and proximal cantilever catches(796, 798) reach a tipping point where distal and proximal cantilevercatches (796, 798) urge left and right actuator sleds (752, 754) to therelease position shown in FIG. 33. In the release position, each distalcantilever catch (796) is respectively engaged with each distal groundcam (814), and each proximal cantilever catch (798) is respectivelyengaged with each proximal ground cam (816) to urge left and rightactuator sleds (752, 754) outward toward the release position. Thereby,distal and proximal detent couplings (800, 802) effectively hold leftand right actuator sleds (752, 754) in the release position to inhibitarms (755 a, 755 b) from inadvertently returning inward and catchingbuttress assembly (712) upon removal of an end effector as discussedherein.

iii. Exemplary Adhesion of Buttress to Surgical Stapler and Cutting ofButtress Assembly with Tissue

As noted above, upper and lower buttress assemblies (712) include upperand lower adhesive layers (742) (or other form of adhesive material) toadhere respective buttresses (714) to an underside of an anvil and deckof a staple cartridge of an end effector. Such adhesive may provideproper positioning of buttress (714) before and during actuation of anend effector; then allow buttress (714) to separate from the endeffector after the end effector has been actuated, without causingdamage to buttress (714) that is substantial enough to compromise theproper subsequent functioning of buttress (714). Buttress assemblies(712) may further incorporate the teachings described in U.S. Pat. App.No. 16/235,473, entitled “Adhesive Distribution on Buttress for SurgicalStapler,” filed on Dec. 28, 2018, published as U.S. Pub. No.2020/0205820 on Jul. 2, 2020, the disclosure of which is herebyincorporated by reference.

By way of example only and not limitation, buttress applier cartridgeassembly (710) can be used to apply buttress assemblies (712) with endeffector (40) as shown and described with respect to FIGS. 15-18. Insuch an instance, buttress assemblies (712) are attached with endeffector (40) in the same manner as described with buttress assemblies(100, 110). Moreover, other end effectors described herein can be usedin place of end effector (40) such that buttress applier cartridgeassembly (710) can be used to apply buttress assemblies (712) with toany of those end effectors. As shown and described above, various endeffectors may have a straight configuration, a bent or curved tipconfiguration where the anvil includes a rigid bent or curved tip, or abent or curved tip configuration where the anvil includes a deformablebent or curve tip. Despite these different configurations, as will bedescribed further below, buttress applier cartridge assembly (710) isconfigured for use with any such configuration end effector.Furthermore, as mentioned above, buttress applier cartridge assembly(710) is configured to accommodate alternative camber orientations of anend effector, including parallel-camber, over-camber, and under-camberorientations. As mentioned above, pad (772) provides sufficientcompression such that adhesive layers (742) of buttresses (714)completely or at least substantially contact the respect parts of theend effector along their longitudinal length to adhere buttresses (712)to the end effector whether the end effector is configured with anover-camber orientation, under-camber orientation, or parallel-camberorientation.

iv. Exemplary Opening Feature Accommodating Curved Tip End Effectors

Referring to buttress applier cartridge (716) as shown in FIGS. 19-33,another feature of buttress applier cartridge (716) pertains to theability for buttress applier cartridge (716) to be used with a varietyof end effectors, including those with a bent or curved tip, which couldbe as part of the anvil or even as part of the cartridge. In thisrespect, buttress applier cartridge (716) comprises an opening (701).Opening (701) is configured as a space or void where a portion of an endeffector can pass through buttress applier cartridge (716) from a topside or upper side to a bottom side or lower side. As will be describedfurther below, when used with an end effector having a curved tip,opening (701) allows for the jaws of the end effector to be closed withthe curved tip passing through opening (701) so that the upper jaw andlower jaw of the end effector can close to at least the point where theupper jaw and lower jaw contact buttress assemblies (712) along its fulllongitudinal length, or at least substantially along its longitudinallength. At the same time, opening (701) does not impede or hinder theuse of straight tip design end effectors.

Referring now to FIGS. 19 and 29-33, in the present example opening(701) is defined by chassis (736) along a distal portion of opening(701) and lateral sides of opening (701). Furthermore, opening isdefined by platform (730) along a proximal portion of opening (701).Thus in the present example, multiple structures or components ofbuttress applier cartridge (716) combine to define opening (701). Insome other versions, opening (701) may be defined by fewer, additional,or other components. Also in the present example, opening (701) isdefined by chassis (736) and platform (730) such that opening (701)comprises a U-shaped opening. In view of the teachings herein, otherways to define opening (701) to provide for alternate opening shapeswill be apparent to those of ordinary skill in the art.

Referring to FIGS. 34 and 35, buttress applier cartridge assembly (710)is shown used with end effector (912). End effector (912) comprises astraight tip configuration, similar to end effectors (12, 40) describedabove. End effector (912) comprises anvil (918) and jaw (916) holding astaple cartridge (937). As shown in FIG. 34, when end effector (912) ispositioned within buttress applier cartridge assembly (710) and closed,opening (701) reveals a portion of cartridge (937) on the other side ofplatform (730). This is the case in this example as end effector (912)is configured such that cartridge (937) extends further distallycompared to anvil (918) when end effector (912) is closed. As shown inFIG. 35, the view from the other side in this configuration shows thatopening (701) is visually blocked by the distal portion of cartridge(937). Nevertheless, buttress applier cartridge assembly (710) isconfigured for use with straight tipped end effectors such as endeffectors (12, 40, 912) described herein, among others.

Referring to FIGS. 36 and 37, buttress applier cartridge assembly (710)is shown used with end effector (1012). End effector (1012) comprises abent or curved tip configuration, similar to end effectors (212, 312,412, 512, 612) described above. End effector (1012) comprises anvil(1018) and jaw (1016) holding a staple cartridge (1037). As shown inFIG. 36, when end effector (1012) is positioned within buttress appliercartridge assembly (710) and closed, opening (701) reveals a portion ofcartridge (1037) on the other side of platform (730). This is the casein this example as end effector (1012) is configured such that cartridge(1037) extends further distally compared to anvil (918) when endeffector (912) is closed and contacting platform (730). As shown in FIG.37, with end effector (1012) closed and contacting platform (730), acurved tip (1014) of anvil (1018) passes through opening (701) extendingtoward cartridge (1037). In the present example, curved tip (1014) isrigid in some versions and deformable in other versions. In eitherconfiguration for curved tip (1014), buttress applier cartridge assembly(710) with opening (701) accommodates anvil (1018) and curved tip (1014)such that curved tip (1014) extends through opening (701) when loadingbuttress assemblies (712) onto end effector (1012).

VII. EXEMPLARY ALTERNATE BUTTRESS APPLIER CARTRIDGE WITH PROXIMALALIGNMENT FEATURE AND DISTAL OPENING TO ACCOMMODATE CURVED TIP ENDEFFECTORS

In other versions of a buttress applier cartridge, an alternate opening,similar to opening (701) described above, can be incorporated into abuttress applier cartridge to accommodate an end effector having acurved tip. Additionally, those buttress applier cartridges describedherein can also include one or more alignment features configured toalign the end effector of the surgical stapler with the buttressassemblies prior to applying the buttress assemblies to the endeffector.

Referring to FIGS. 38-41, buttress applier cartridge assembly (2110) isshown, which is similar to buttress applier cartridge assembly (710)shown and described above. To that extent, the teachings above withrespect to buttress applier cartridge assembly (710) apply equally tobuttress applier cartridge assembly (2110) except for the differencesdescribed below. Buttress applier cartridge assembly (2110) comprisesbuttress applier cartridge (2116) having housing assembly (724), whichhas upper housing (726) and lower housing (728). In the present example,housing assembly (724) defines a channel (2103) that is open at aproximal end and configured to accommodate an end effector, such as endeffector (1012) as shown in FIGS. 39 and 41.

Buttress applier cartridge (2116) further comprises chassis (2136) andplatform (2130). In some examples similar to the configuration forbuttress applier cartridge (716) described above, chassis (2136) isconnectable with housing assembly (724), and platform (2130) isconnectable with chassis (2136). In this manner platform (2130) isconnectable with housing assembly (724) indirectly via chassis (2136).Still in other examples buttress applier cartridges (716, 2116) can beconfigured such that platform (2136) may be directly connectable withhousing assembly (724).

As best seen in FIG. 38, platform (2130) is configured to retainbuttress assemblies (712) in the same manner as described above withrespect to buttress applier cartridge (716). In the present example,platform (2130) is compressible and also extends proximally to distallysuch that the space or area defined by channel (2103) is encompassed byplatform (2130). Near a distal end of channel (2103), platform (2130)includes opening (2101), which is defined by a hole or cut-out inplatform (2130). With this configuration, opening (2101) is locateddistal to where one or more buttress assemblies (712) are supported orsupportable by platform (2130). In the present example, opening (2101)comprises a U-shaped cut-out. In this manner, opening (2101) is formedin platform (2130), and defined on all sides by platform (2130). Similarto opening (701) described above, opening (2101) is configured to allowcurved tip (1014) of end effector (1012) or another similar end effectorto pass through platform (2130) and/or chassis (2136). In this mannercurved tip (1014) extends transversely from one side of combined chassis(2136) and platform (2130) to the other side.

Opening (2101) can be configured to be oversized relative to curved tip(1014), undersized relative to curved tip (1014), or equal orsubstantially equal in size to curved tip (1014). In some cases, such aswith U-shaped opening (2101) described here and shown in FIG. 38,platform (2130) comprises a resilient material such that opening (2101)defined by platform (2130) is expandable, for instance when curved tip(1014) extends through opening (2101) and presses against sides ofopening (2101). Also in some cases, such as with U-shaped opening(2101), opening (2101) can be configured with a shape that resembles anoutline of the shape of curved tip (1014) of end effector (1012). Inthis way the shape of opening (2101) and curved tip (1014) of endeffector (1012) are complementary. In view of the teachings herein,other configurations for opening (2101) will be apparent to those ofordinary skill in the art.

Similar to platform (730) described above, platform (2130) is configuredto be thicker at a distal portion (2180) proximal to opening (2101)compared to a proximal portion (2178) of platform (2130). In this mannerplatform (2130) comprises a taper from distal portion (2180) to proximalportion (2178). Stated another way, platform (2130) increases inthickness from proximal portion (2178) to distal portion (2180). Asshown in the present example of FIG. 38, opening (2101) is locatedfurther distally on platform (2130) relative to distal portion (2180).Additionally in the present example, as shown in FIGS. 40 and 41, theportion of platform (2130) with opening (2101) is thinner relative todistal portion (2180).

Referring again to FIG. 39, in defining channel (2103), housing assembly(724) comprises a V-shaped or U-shaped recess (2105) at the distal endof channel (2103). In this manner, recess (2105) is configured toaccommodate distal end or distal tip (1019) of curved tip (1014).Referring again to FIG. 38, in the present example, opening (2101) islocated within the area defined by recess (2105). In this manner,buttress applier cartridge (2116) is configured to accommodate curvedtip (1014) and distal end (1019) at least with features provided onhousing assembly (724) and platform (2130). In addition to providingspace to accommodate distal end (1019) of curved tip (1014) of endeffector (1012), in some instances recess (2105) may further assist inguiding or aligning end effector (1012) when clamping end effector(1012) onto platform (2130) such that end effector (1012) can pick-upbuttress assemblies (712). However, as described below, other alignmentfeatures or structures can also be provided with buttress appliercartridge (2116) instead of, or in addition to, any alignment providedby recess (2105).

Referring to FIGS. 38, 40, and 41, buttress applier cartridge (2116)also includes an alignment feature (2132) located at a proximal end ofbuttress applier cartridge (2116). In the present example, alignmentfeature (2132) comprises a thin rigid portion that extends laterallyacross the width of channel (2103). In this fashion, alignment features(2132) extends orthogonally relative to the longitudinally extendingchannel (2103). When end effector (1012) is fully positioned withbuttress applier cartridge (2116) as shown in FIG. 40, alignment feature(2132) extends across the cut-line defined by a vertical slot of the endeffector where a firing beam travels to sever clamped tissue, the sameor similar to vertical slot (49) and firing beam (14) of end effector(12) described above. In some other versions, alignment feature (2132)may extend to a greater or lesser extent laterally across the width ofchannel (2103) and the cut-line defined by the end effector.

Alignment feature (2132) is configured as a proximal alignment feature.In this way, alignment feature (2132) is configured to engage or contacta proximal edge or one or more tissue stops of the end effector when theend effector is open prior to clamping but fully positioned withbuttress applier cartridge (2116) within channel (2103). In someinstances, the proximal edge or one or more tissue stops of the endeffector may be located on the jaw of the end effector comprising thestaple cartridge. In some other instances, the proximal edge or one ormore tissue stops of the end effector may be located on the jaw of theend effector comprising the anvil.

As shown in FIGS. 40 and 41, alignment feature (2132) is configured tocontact proximal edge (1016) of end effector (1012). In some cases,proximal edge (1016) is operable as a tissue stop such that proximaledge (1016) is prevents over inserting tissue within end effector (1012)to ensure a complete cutting and stapling of the target tissue. In othercases, one or more dedicated tissue stops extend from the end effector,and in such cases alignment feature (2132) is configured to contact suchtissue stops. Referring to FIGS. 42 and 43, an end effector (912) isshown fully positioned with another buttress applier cartridge (2216),which is shown with housing assembly (724) removed. Alignment feature(2132) is located at the proximal end and extending from platform(2230). Alignment feature (2132) contacts tissue stop (915) as best seenin FIG. 43.

Referring again to FIGS. 40 and 41, alignment feature (2132) isconnectable with platform (2130) and extends proximally from platform(2130). Furthermore, as shown in the present example, alignment feature(2132) is thinner than the adjacent part of platform (2130) from whichalignment feature (2132) extends. In this way, alignment feature (2132)is configured to not interfere with the end effector clamping ontoplatform (2130) to pick-up buttress assemblies (712). Additionally asshown, alignment feature (2132) is positioned between where buttressassemblies (712) are supported or supportable by platform (2130). Insome versions, alignment feature (2132) comprises a separate rigidstructure that connects with platform (2130). However, in otherversions, alignment feature (2132) may be a rigid proximal part or endof platform (2130) itself, such that alignment feature (2132) is formedas part of platform (2130).

When an end effector is used with a buttress applier cartridge havingalignment feature (2132), alignment feature (2132) guides the endeffector to align the end effector relative to the buttress assemblies(712) supported by the buttress applier cartridge. Thus alignmentfeature (2132) is configured as a proximal alignment feature that alignsa longitudinal position of the end effector, including aligning thedistal part of the end effector.

In the illustrated example of FIGS. 39-41 where end effector (1012) isused with buttress applier cartridge assembly (2110), proximal edge(1016) is used to align longitudinal position of end effector (1012)relative to platform (2130) and buttress assemblies (712) supportedthereon. Additionally, in the present example, alignment feature (2132)is configured to guide curved tip (1014) of end effector (1012) to aligncurved tip (1014) with opening (2101). In this way, buttress appliercartridge (2116) is configured so that the spacing between opening(2101) and alignment feature (2132) will allow for curved tip (1014) ofend effector (1012) to align with opening (2101) when proximal edge(1016) of end effector (1012) contacts alignment feature (2132) prior toclamping end effector (1012) on platform (2130). Furthermore, whensubsequently clamping end effector (1012), the alignment of curved tip(1014) with opening (2101) allows at least a portion of curved tip(1014) to extend through or pass through opening (2101). As shown inFIG. 41, when this occurs, opening (2101) deforms such that the portionof platform (2130) around opening (2101) deflects downward away fromcurved tip (1014) as curved tip (1014) contacts platform (2130) andpushes platform (2130) downward. In view of the teachings herein, otherways to incorporate one or more alignment features with a buttressapplier cartridge that align an end effector of a surgical stapler withthe buttress applier cartridge, or ways to modify alignment feature(2132) for use with such an end effector will be apparent to those ofordinary skill in the art.

The various buttress applier cartridges described herein may be usedwith any of the end effectors described herein. By way of example, andnot limitation, those features of the buttress applier cartridges thatare configured to work with and/or accommodate an end effector having acurved tip make the buttress applier cartridges suitable for use withend effectors having various styles and configurations for the curvedtip. For instance, the buttress applier cartridges described herein withfeatures for a curved tip end effector can be used with end effectorswhere the curved tip may be gradually curved, or where the curved tipmay be non-aligned or at an angle relative to the axis of the anvil suchthat the curved tip has a more angled or bent configuration rather thangradual curve. Also, the buttress applier cartridges with features toaccommodate end effectors with a curved tip described herein can be usedwith, or configured for use with, end effectors where the curved tipportion is spaced from the distal end of the cartridge or terminates atthe same or similar point as the distal end of the cartridge. Also, thebuttress applier cartridges with features to accommodate end effectorswith a curved tip described herein can be used, or configured for usewith, end effectors that have curved tips configured for different usesor applications such as atraumatic tips, dissecting tips, visualizationtips, placement tips, deflectable or deformable tips, and combinationsthereof, etc. In view of the teachings herein, other ways to configurethe buttress applier cartridges described herein to work with the endeffectors described herein will be apparent to those of ordinary skillin the art.

VIII. EXEMPLARY COMBINATIONS

The following examples relate to various non-exhaustive ways in whichthe teachings herein may be combined or applied. It should be understoodthat the following examples are not intended to restrict the coverage ofany claims that may be presented at any time in this application or insubsequent filings of this application. No disclaimer is intended. Thefollowing examples are being provided for nothing more than merelyillustrative purposes. It is contemplated that the various teachingsherein may be arranged and applied in numerous other ways. It is alsocontemplated that some variations may omit certain features referred toin the below examples. Therefore, none of the aspects or featuresreferred to below should be deemed critical unless otherwise explicitlyindicated as such at a later date by the inventors or by a successor ininterest to the inventors. If any claims are presented in thisapplication or in subsequent filings related to this application thatinclude additional features beyond those referred to below, thoseadditional features shall not be presumed to have been added for anyreason relating to patentability.

Example 1

A buttress applier cartridge is configured to retain one or morebuttress assemblies. The buttress applier cartridge is furtherconfigured for use with an end effector of a surgical stapler to applythe one or more buttress assemblies to a select one or more of a firstjaw and a second jaw of the end effector. The first jaw of the endeffector comprises an anvil and the second jaw of the end effectorcomprises a staple cartridge. The buttress applier cartridge comprises(a) a housing assembly having a proximal end and a distal end. Thehousing assembly defines a channel extending longitudinally andconfigured to receive the end effector. The buttress applier cartridgefurther comprises (b) a platform, directly or indirectly connectablewith the housing assembly. The platform extends longitudinally within anarea defined by the channel, and is configured to support the one ormore buttress assemblies thereon. The buttress applier cartridge furthercomprises (c) an opening that extends transversely from a first side ofthe platform to a second side of the platform opposite the first side ofthe platform. The opening is configured to receive a curved tip of theend effector, allowing at least a portion of the curved tip to extendfrom the first side of the platform to the second side of the platform.The buttress applier cartridge further comprises (d) an alignmentfeature connectable with the platform, and extending proximallytherefrom. The alignment feature is configured to contact a tissue stopof the end effector when the end effector is fully positioned within thechannel defined by the housing assembly.

Example 2

The buttress applier cartridge of Example 1, wherein the alignmentfeature is rigid.

Example 3

The buttress applier cartridge of any one or more of Example 1 throughExample 2, wherein the alignment feature is thinner than the platform.

Example 4

The buttress applier cartridge of any one or more of Example 1 throughExample 3, wherein the alignment feature is positioned between where theone or more buttress assemblies that are supportable by the platform.

Example 5

The buttress applier cartridge of any one or more of Example 1 throughExample 4, wherein the alignment feature extends orthogonally relativeto the longitudinally extending channel such that the alignment featureextends across a cut line defined by the end effector when the endeffector is positioned within the channel.

Example 6

The buttress applier cartridge of any one or more of Example 1 throughExample 5, wherein the alignment feature connects with a proximal end ofthe platform.

Example 7

The buttress applier cartridge of any one or more of Example 1 throughExample 6, wherein the alignment feature is configured to guide thecurved tip of the end effector to align the curved tip of the endeffector with the opening.

Example 8

The buttress applier cartridge of any one or more of Example 1 throughExample 7, wherein the alignment feature is formed as part of theplatform.

Example 9

The buttress applier cartridge of any one or more of Example 1 throughExample 8, wherein the platform increases in thickness from a proximalportion to a distal portion.

Example 10

The buttress applier cartridge of any one or more of Example 1 throughExample 9, wherein the platform is compressible.

Example 11

The buttress applier cartridge of any one or more of Example 1 throughExample 10, further comprising a chassis, wherein the chassis connectswith the housing assembly and the platform connects with the chassis.

Example 12

The buttress applier cartridge of any one or more of Example 1 throughExample 11, wherein the opening comprises a U-shaped cut-out.

Example 13

The buttress applier cartridge of any one or more of Example 1 throughExample 12, wherein the opening is located distal to where the one ormore buttress assemblies are supportable by the platform.

Example 14

The buttress applier cartridge of any one or more of Example 1 throughExample 13, wherein clamping the end effector on the platform causes thecurved tip of the end effector to at least partially extend through theopening.

Example 15

The buttress applier cartridge of any one or more of Example 1 throughExample 14, wherein the opening deforms when the curved tip passesthrough the opening.

Example 16

The buttress applier cartridge of any one or more of Example 1 throughExample 15, wherein the opening and alignment feature are spaced suchthat when the tissue stops of the end effector contact the alignmentfeature and the end effector is clamped, the curved tip of the endeffector aligns with and extends through the opening.

Example 17

The buttress applier cartridge of any one or more of Example 1 throughExample 16, further configured such that a proximal edge of a select oneof the first jaw and second jaw of the end effector are used to alignlongitudinal position of the end effector relative to the platform andthe one or more buttress assemblies configured to be supported by theplatform.

Example 18

The buttress applier cartridge of any one or more of Example 1 throughExample 17, wherein the curved tip of the end effector is a dissectingtip.

Example 19

A buttress applier cartridge assembly is configured for use with an endeffector of a surgical stapler. The buttress applier cartridge assemblycomprises (a) a buttress assembly configured to be selectively adheredthe end effector when clamping the end effector on the buttress appliercartridge assembly. The buttress applier cartridge assembly furthercomprises (b) a buttress applier cartridge selectively retaining thebuttress assembly, wherein the buttress applier cartridge comprises (i)a platform extending longitudinally from a proximal portion to a distalportion. The platform is configured to selectively support the buttressassembly, and to receive the end effector. The buttress appliercartridge further comprises (ii) an opening extending transversely froma first side of the platform to a second side of the platform oppositethe first side of the platform. The opening is configured to receive acurved tip of the end effector allowing at least a portion of the curvedtip to pass through the opening from the first side of the platform tothe second side of the platform. The buttress applier cartridge furthercomprises (iii) an alignment feature located at a proximal end of thebuttress applier cartridge and configured to contact a proximal edge ofthe end effector prior to clamping the end effector on the platform toguide the end effector into alignment with the buttress assemblysupported by the platform prior to clamping the end effector.

Example 20

A buttress application system comprises (a) an end effector for asurgical stapler. The end effector comprises a first jaw and a secondjaw. The first jaw of the end effector comprises an anvil and the secondjaw of the end effector comprises a staple cartridge. The end effectorfurther comprises a curved tip and one or more tissue stops. Thebuttress application system further comprises (b) a pair of buttressassemblies, each comprising a buttress and an adhesive. A first buttressassembly of the pair of buttress assemblies is configured to beselectively adhered to the first jaw of the end effector, and a secondbuttress assembly of the pair of buttress assemblies is configured to beselectively adhered to the second jaw of the end effector. The buttressapplication system further comprises (c) a buttress applier cartridgeconfigured to selectively retain the buttress assemblies and apply thebuttress assemblies to the end effector. The buttress applier cartridgecomprises (i) a housing defining a channel extending longitudinally. Thechannel is open at a proximal end and configured to receive the endeffector. The buttress applier cartridge further comprises (ii) aplatform extending longitudinally and operatively connected to thehousing directly or indirectly. The platform supports the buttressassemblies thereon. The buttress applier cartridge further comprises(iii) an opening that extends transversely from a first side of theplatform to a second side of the platform opposite the first side of theplatform. The opening is configured to receive a curved tip of the endeffector when the end effector is clamped onto the platform. Thebuttress applier cartridge further comprises (iv) an alignment featureconnectable with the platform. The alignment feature extends proximallyfrom the platform. The alignment feature is configured to contact theone or more tissue stops of the end effector when the end effector isopen and positioned within the channel defined by the housing assembly.

IX. MISCELLANEOUS

It should be understood that any one or more of the teachings,expressions, embodiments, examples, etc. described herein may becombined with any one or more of the other teachings, expressions,embodiments, examples, etc. that are described herein. Theabove-described teachings, expressions, embodiments, examples, etc.should therefore not be viewed in isolation relative to each other.Various suitable ways in which the teachings herein may be combined willbe readily apparent to those of ordinary skill in the art in view of theteachings herein. Such modifications and variations are intended to beincluded within the scope of the claims.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. Pat. No. D836,198, entitled“Surgical Stapler End Effector with Varying Deck Height and TissueGripping Features,” issued Dec. 18, 2018, the disclosure of which isincorporated by reference herein. Various suitable ways in which theteachings herein may be combined with the teachings of U.S. Pat. No.D836,198, will be apparent to those of ordinary skill in the art.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. Pat. No. D833,010, entitled“Circular Surgical Stapler End Effector with Varying Deck Height andTissue Gripping Features,” issued Nov. 6, 2018, the disclosure of whichis incorporated by reference herein. Various suitable ways in which theteachings herein may be combined with the teachings of U.S. Pat. No.D833,010, will be apparent to those of ordinary skill in the art.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. Pat. Pub. No. 2018/0235610,entitled “Surgical Stapler with Insertable Distal Anvil Tip,” publishedAug. 23, 2018, issued as U.S. Pat. No. 10,729,434 on Aug. 4, 2020, thedisclosure of which is incorporated by reference herein. Varioussuitable ways in which the teachings herein may be combined with theteachings of U.S. Pat. Pub. No. 2018/0235610, issued as U.S. Pat. No.10,729,434 on Aug. 4, 2020, will be apparent to those of ordinary skillin the art.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. Pat. Pub. No. 2018/0235611,entitled “Surgical Stapler with Cooperating Distal Tip Features on Anviland Staple Cartridge,” published Aug. 23, 2018, the disclosure of whichis incorporated by reference herein. Various suitable ways in which theteachings herein may be combined with the teachings of U.S. Pat. Pub.No. 2018/0235611, will be apparent to those of ordinary skill in theart.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. Pat. No. D836,199, entitled“Surgical Stapler with Bent Anvil Tip and Angled Staple Cartridge Tip,”issued Dec. 18, 2018, the disclosure of which is incorporated byreference herein. Various suitable ways in which the teachings hereinmay be combined with the teachings of U.S. Pat. No. D836,199, will beapparent to those of ordinary skill in the art.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. Pat. Pub. No. 2018/0235619,entitled “Surgical Stapler with Bent Anvil Tip, Angled Staple CartridgeTip, and Tissue Gripping Features,” published Aug. 23, 2018, issued asU.S. Pat. No. 10,758,231 on Sep. 1, 2020, the disclosure of which isincorporated by reference herein. Various suitable ways in which theteachings herein may be combined with the teachings of U.S. Pat. Pub.No. 2018/0235619, issued as U.S. Pat. No. 10,758,231 on Sep. 1, 2020,will be apparent to those of ordinary skill in the art.

It should also be understood that the teachings herein may be readilycombined with various teachings in U.S. patent application Ser. No.16/035,893, entitled “Method of Surgical Stapling with End EffectorComponent Having a Curved Tip,” filed Jul. 16, 2018, the disclosure ofwhich is incorporated by reference herein. Various suitable ways inwhich the teachings herein may be combined with the teachings of U.S.patent application Ser. No. 16/035,893, published as U.S. Pat. No.2019/0000481 on Jul. 3, 2019, will be apparent to those of ordinaryskill in the art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Versions of the devices described above may have application inconventional medical treatments and procedures conducted by a medicalprofessional, as well as application in robotic-assisted medicaltreatments and procedures. By way of example only, various teachingsherein may be readily incorporated into a robotic surgical system suchas the DAVINCI™ system by Intuitive Surgical, Inc., of Sunnyvale, Calif.Similarly, those of ordinary skill in the art will recognize thatvarious teachings herein may be readily combined with various teachingsof any of the following: U.S. Pat. No. 5,792,135, entitled “ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery WithEnhanced Dexterity and Sensitivity,” issued Aug. 11, 1998, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.5,817,084, entitled “Remote Center Positioning Device with FlexibleDrive,” issued Oct. 6, 1998, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 5,878,193, entitled “Automated EndoscopeSystem for Optimal Positioning,” issued Mar. 2, 1999, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 6,231,565,entitled “Robotic Arm DLUS for Performing Surgical Tasks,” issued May15, 2001, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool with UltrasoundCauterizing and Cutting Instrument,” issued Aug. 31, 2004, thedisclosure of which is incorporated by reference herein; U.S. Pat. No.6,364,888, entitled “Alignment of Master and Slave in a MinimallyInvasive Surgical Apparatus,” issued Apr. 2, 2002, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 7,524,320,entitled “Mechanical Actuator Interface System for Robotic SurgicalTools,” issued Apr. 28, 2009, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 7,691,098, entitled “Platform Link WristMechanism,” issued Apr. 6, 2010, the disclosure of which is incorporatedby reference herein; U.S. Pat. No. 7,806,891, entitled “Repositioningand Reorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery,” issued Oct. 5, 2010, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,844,789, entitled“Automated End Effector Component Reloading System for Use with aRobotic System, issued Sep. 30, 2014, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,820,605, entitled“Robotically-Controlled Surgical Instrument with Force-FeedbackCapabilities,” issued Sep. 2, 2014, the disclosure of which isincorporated by reference herein; U.S. Pat. No. 8,616,431, entitled“Shiftable Drive Interface for Robotically-Controlled Surgical Tool,”issued Dec. 31, 2013, the disclosure of which is incorporated byreference herein; U.S. Pat. No. 8,573,461, entitled “Surgical StaplingInstruments with Cam-Driven Staple Deployment Arrangements,” issued Nov.5, 2013, the disclosure of which is incorporated by reference herein;U.S. Pat. No. 8,602,288, entitled “Robotically-Controlled MotorizedSurgical End Effector System with Rotary Actuated Closure Systems HavingVariable Actuation Speeds,” issued Dec. 10, 2013, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 9,301,759,entitled “Robotically-Controlled Surgical Instrument with SelectivelyArticulatable End Effector,” issued Apr. 5, 2016, the disclosure ofwhich is incorporated by reference herein; U.S. Pat. No. 8,783,541,entitled “Robotically-Controlled Surgical End Effector System,” issuedJul. 22, 2014, the disclosure of which is incorporated by referenceherein; U.S. Pat. No. 8,479,969, entitled “Drive Interface for OperablyCoupling a Manipulatable Surgical Tool to a Robot,” issued Jul. 9, 2013;U.S. Pat. No. 8,800,838, entitled “Robotically-Controlled Cable-BasedSurgical End Effectors,” issued Aug. 12, 2014, the disclosure of whichis incorporated by reference herein; and/or U.S. Pat. No. 8,573,465,entitled “Robotically-Controlled Surgical End Effector System withRotary Actuated Closure Systems,” issued Nov. 5, 2013, the disclosure ofwhich is incorporated by reference herein.

Versions of the devices described above may be designed to be disposedof after a single use, or they can be designed to be used multipletimes. Versions may, in either or both cases, be reconditioned for reuseafter at least one use. Reconditioning may include any combination ofthe steps of disassembly of the device, followed by cleaning orreplacement of particular pieces, and subsequent reassembly. Inparticular, some versions of the device may be disassembled, and anynumber of the particular pieces or parts of the device may beselectively replaced or removed in any combination. Upon cleaning and/orreplacement of particular parts, some versions of the device may bereassembled for subsequent use either at a reconditioning facility, orby a user immediately prior to a procedure. Those skilled in the artwill appreciate that reconditioning of a device may utilize a variety oftechniques for disassembly, cleaning/replacement, and reassembly. Use ofsuch techniques, and the resulting reconditioned device, are all withinthe scope of the present application.

By way of example only, versions described herein may be sterilizedbefore and/or after a procedure. In one sterilization technique, thedevice is placed in a closed and sealed container, such as a plastic orTYVEK bag. The container and device may then be placed in a field ofradiation that can penetrate the container, such as gamma radiation,x-rays, or high-energy electrons. The radiation may kill bacteria on thedevice and in the container. The sterilized device may then be stored inthe sterile container for later use. A device may also be sterilizedusing any other technique known in the art, including but not limited tobeta or gamma radiation, ethylene oxide, or steam.

Having shown and described various embodiments of the present invention,further adaptations of the methods and systems described herein may beaccomplished by appropriate modifications by one of ordinary skill inthe art without departing from the scope of the present invention.Several of such potential modifications have been mentioned, and otherswill be apparent to those skilled in the art. For instance, theexamples, embodiments, geometrics, materials, dimensions, ratios, steps,and the like discussed above are illustrative and are not required.Accordingly, the scope of the present invention should be considered interms of the following claims and is understood not to be limited to thedetails of structure and operation shown and described in thespecification and drawings.

We claim:
 1. A buttress applier cartridge configured to retain one ormore buttress assemblies, wherein the buttress applier cartridge isfurther configured for use with an end effector of a surgical stapler toapply the one or more buttress assemblies to a select one or more of afirst jaw and a second jaw of the end effector, wherein the first jaw ofthe end effector comprises an anvil and the second jaw of the endeffector comprises a staple cartridge, wherein the buttress appliercartridge comprises: (a) a housing assembly having a proximal end and adistal end, wherein the housing assembly defines a channel extendinglongitudinally and configured to receive the end effector; (b) aplatform, directly or indirectly connectable with the housing assembly,wherein the platform extends longitudinally within an area defined bythe channel, wherein the platform is configured to support the one ormore buttress assemblies thereon; (c) an opening that extendstransversely from a first side of the platform to a second side of theplatform opposite the first side of the platform, wherein the opening isconfigured to receive a curved tip of the end effector allowing at leasta portion of the curved tip to extend from the first side of theplatform to the second side of the platform; and (d) an alignmentfeature, wherein the alignment feature is connectable with the platformand extends proximally therefrom, wherein the alignment feature isconfigured to contact a tissue stop of the end effector when the endeffector is fully positioned within the channel defined by the housingassembly.
 2. The buttress applier cartridge of claim 1, wherein thealignment feature is rigid.
 3. The buttress applier cartridge of claim1, wherein the alignment feature is thinner than the platform.
 4. Thebuttress applier cartridge of claim 1, wherein the alignment feature ispositioned between where the one or more buttress assemblies that aresupportable by the platform.
 5. The buttress applier cartridge of claim1, wherein the alignment feature extends orthogonally relative to thelongitudinally extending channel such that the alignment feature extendsacross a cut line defined by the end effector when the end effector ispositioned within the channel.
 6. The buttress applier cartridge ofclaim 1, wherein the alignment feature connects with a proximal end ofthe platform.
 7. The buttress applier cartridge of claim 1, wherein thealignment feature is configured to guide the curved tip of the endeffector to align the curved tip of the end effector with the opening.8. The buttress applier cartridge of claim 1, wherein the alignmentfeature is formed as part of the platform.
 9. The buttress appliercartridge of claim 1, wherein the platform increases in thickness from aproximal portion to a distal portion.
 10. The buttress applier cartridgeof claim 1, wherein the platform is compressible.
 11. The buttressapplier cartridge of claim 1, further comprising a chassis, wherein thechassis connects with the housing assembly and the platform connectswith the chassis.
 12. The buttress applier cartridge of claim 1, whereinthe opening comprises a U-shaped cut-out.
 13. The buttress appliercartridge of claim 1, wherein the opening is located distal to where theone or more buttress assemblies are supportable by the platform.
 14. Thebuttress applier cartridge of claim 1, wherein clamping the end effectoron the platform causes the curved tip of the end effector to at leastpartially extend through the opening.
 15. The buttress applier cartridgeof claim 1, wherein the opening deforms when the curved tip passesthrough the opening.
 16. The buttress applier cartridge of claim 1,wherein the opening and alignment feature are spaced such that when thetissue stops of the end effector contact the alignment feature and theend effector is clamped, the curved tip of the end effector aligns withand extends through the opening.
 17. The buttress applier cartridge ofclaim 1, further configured such that a proximal edge of a select one ofthe first jaw and second jaw of the end effector are used to alignlongitudinal position of the end effector relative to the platform andthe one or more buttress assemblies configured to be supported by theplatform.
 18. The buttress applier cartridge of claim 1, wherein thecurved tip of the end effector is a dissecting tip.
 19. A buttressapplier cartridge assembly configured for use with an end effector of asurgical stapler, wherein the buttress applier cartridge assemblycomprises: (a) a buttress assembly configured to be selectively adheredthe end effector when clamping the end effector on the buttress appliercartridge assembly; and (b) a buttress applier cartridge selectivelyretaining the buttress assembly, wherein the buttress applier cartridgecomprises: (i) a platform extending longitudinally from a proximalportion to a distal portion, wherein the platform is configured toselectively support the buttress assembly, wherein the platform isfurther configured to receive the end effector, (ii) an openingextending transversely from a first side of the platform to a secondside of the platform opposite the first side of the platform, whereinthe opening is configured to receive a curved tip of the end effectorallowing at least a portion of the curved tip to pass through theopening from the first side of the platform to the second side of theplatform, and (iii) an alignment feature located at a proximal end ofthe buttress applier cartridge and configured to contact a proximal edgeof the end effector prior to clamping the end effector on the platformto guide the end effector into alignment with the buttress assemblysupported by the platform prior to clamping the end effector.
 20. Abuttress application system comprising: (a) an end effector for asurgical stapler, wherein the end effector comprises a first jaw and asecond jaw, wherein the first jaw of the end effector comprises an anviland the second jaw of the end effector comprises a staple cartridge,wherein the end effector further comprises a curved tip and one or moretissue stops; (b) a pair of buttress assemblies, each comprising abuttress and an adhesive, wherein a first buttress assembly of the pairof buttress assemblies is configured to be selectively adhered to thefirst jaw of the end effector, and wherein a second buttress assembly ofthe pair of buttress assemblies is configured to be selectively adheredto the second jaw of the end effector; and (c) a buttress appliercartridge configured to selectively retain the buttress assemblies andapply the buttress assemblies to the end effector, wherein the buttressapplier cartridge comprises: (i) a housing defining a channel extendinglongitudinally, wherein the channel is open at a proximal end andconfigured to receive the end effector, (ii) a platform extendinglongitudinally and operatively connected to the housing directly orindirectly, wherein the platform supports the buttress assembliesthereon, (iii) an opening that extends transversely from a first side ofthe platform to a second side of the platform opposite the first side ofthe platform, wherein the opening is configured to receive a curved tipof the end effector when the end effector is clamped onto the platform,and (iv) an alignment feature connectable with the platform, wherein thealignment feature extends proximally from the platform, wherein thealignment feature is configured to contact the one or more tissue stopsof the end effector when the end effector is open and positioned withinthe channel defined by the housing assembly.